Multiple-domain Versus Single-domain Measurements of Socioeconomic Status (SES) for Predicting Nonadherence to Statin Medications

An Observational Population-based Cohort Study

Datos Bibliográficos

ID9101313
AutoresMhd Wasem Alsabbagh (0000-0002-2426-9528, University of Waterloo, autor de correspondencia), Lisa M Lix (0000-0001-8685-3212, University of Manitoba), Dean T Eurich (0000-0003-2197-0463, University of Alberta), Dean Eurich, Thomas W Wilson (0000-0002-0670-5824, Royal University Hospital), David F Blackburn, David Blackburn (0000-0002-7831-5913, University of Saskatchewan)
Año2016
Volumen54
Número2
Páginas195-204
Fecha de publicación2016-02-01
Peer ReviewedSí
Open AccessNo
TipoARTICLE
RevistaMedical Care (JOURNAL)
Identificadores de la revistaISSN: 0025-7079 • E-ISSN: 1537-1948
EditorialOvid Technologies (Wolters Kluwer Health) (PUBLISHER)
DOI10.1097/mlr.0000000000000468
PMID26683784
OpenAlexW2409479736
IdiomaEN
Citas recibidas1
Referencias citadas43

INTRODUCTION: Low socioeconomic status (SES) should be a robust predictor of medication nonadherence because it shares key features with the theoretical origins of this phenomenon. However, population-based studies have demonstrated weak associations overall, possibly because SES is inadequately represented. We compared the performance of multiple versus single-domain measures of SES as predictors of statin adherence. METHODS: This retrospective cohort study used population-based administrative data mapped to area-level census information of individuals who received a statin medication following a hospitalization for coronary heart disease. One-year adherence was calculated by dividing the sum of all tablets dispensed by the total number of days in the observation period (365 d following the first statin dispensation). Logistic regression models were constructed and the relative impact of each SES measure was assessed by its adjusted odds ratio (OR) and improvement over the predictive accuracy of a reference model that included non-SES factors only. RESULTS: More than two thirds (ie, 68.8%; 6517/9478) of eligible individuals exhibited optimal adherence (ie, ≥80%). The estimated impact of SES on optimal adherence differed depending on the SES measure tested. The highest performing single-domain measure, household income (OR=0.75; 95% confidence interval, 0.63-0.90; model c-statistic improvement 0.5%, P=0.04) generated a similar result to the multiple-domain measure (adjusted OR=0.74; 95% confidence interval, 0.62-0.88; model c-statistic improvement 0.7%, P=0.01). CONCLUSION: Multidomain measurements of SES using administrative databases mapped to census data are not associated with better performance in predicting statin medication adherence compared with single-domain measures such as household income

Confidence interval · Environmental health · Logistic regression · Odds · Odds ratio · Population · Retrospective cohort study · Socioeconomic status · Statin · Statistic · Statistics · Advanced Causal Inference Techniques · Chronic Disease Management Strategies · Demography · Internal Medicine · Mathematics · Medication Adherence and Compliance · Medicine