Korean J Fam Pract. 2017; 7(6): 926-932  https://doi.org/10.21215/kjfp.2017.7.6.926
Severity of Disability and Antihypertensive Medication Adherence in Korea
Seung Jae Kim1, Ho Chun Choi2,*, Cheol Min Lee2, Seung-Won Oh2, Hee-Kyung Joh3,4, Bumjo Oh5, Oh Deog Kwon1, Arang Lee1, Kwang Ho Oh1
1Department of Family Medicine, Seoul National University Hospital, Seoul National University College of Medicine; 2Department of Family Medicine, Seoul National University Hospital Healthcare System Gangnam Center, Seoul National University College of Medicine; 3Department of Medicine, Seoul National University College of Medicine; 4Department of Family Medicine, Seoul National University Health Service Center; 5Department of Family Medicine, SMG-SNU Boramae Medical Center, Seoul, Korea
Ho Chun Choi
Tel: +82-2-2112-5745, Fax: +82-2-2114-5794
E-mail: skyho331@gmail.com
Received: July 6, 2017; Revised: September 3, 2017; Accepted: September 15, 2017; Published online: December 20, 2017.
© The Korean Academy of Family Medicine. All rights reserved.

This is an open-access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0) which permits unrestricted noncommercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
Abstract
Background: Disabled patients exhibit poor antihypertensive medication adherence. In the absence of representative field studies, we investigated the differences and factors related to antihypertensive medication adherence between disabled and non-disabled people.
Methods: A sample set equivalent to 2% of the total Korean population, based on the National Health Insurance Service-National Sample Cohort for 2008 to 2013, included all patients over 20 years of age on antihypertensive drug therapy for hypertension for at least one year. The subjects were divided into three groups according to severity of disability: no disability (n=134,074), mild disability (n=3,219), or severe disability (n=13,527).
Results: Medication adherence was compared between groups. Medication, comorbidities, and socioeconomic factors were evaluated using stepwise adjustment to determine the main factors. The odds ratios of socioeconomic factors were analyzed using logistic regression. The medication possession ratio was 80.9% in those with no disability, 73.7% in those with mild disability, and 78.6% in those with severe disability. When adjusted for socioeconomic factors, the differences in medication adherence between the three groups were clinically insignificant. When compared with nondisabled patients, the odds ratios for receiving medical assistance or having low income were 5.1 and 1.8 (95% confidence interval, CI), respectively, in those with mild disability, and 1.6 and 1.1 (95% CI) in those with severe disability.
Conclusion: Disabled patients exhibit lower adherence to antihypertensive medication than nondisabled patients. Socioeconomic factors have a greater influence on adherence than other factors.
Keywords: Disabled Persons; Antihypertensive Drugs; Medication Adherence; Socioeconomic Factors
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