Article Figures & Data
Tables
- Table 1.
Medications, typical indications, and corresponding Anatomic Therapeutic Chemical codes selected for the study
MEDICATION CLASS TYPICAL INDICATIONS CODES Antibiotics Infection J01, G04A Antidepressants Depression N06A Antihypertensives Hypertension C02, C03, C04, C05, C07, C08, C09 Benzodiazepines Anxiety N05BA, N03AE Bisphosphonates Osteoporosis M05B Hypoglycemics Diabetes A10 Lipid-lowering agents Cardiovascular disease, hyperlipidemia C10 CHARACTERISTIC ANTIBIOTICS, n (%) (N=37,402)* ANTIDEPRESSANTS, n (%) (N=14,257)* ANTIHYPERTENSIVES, n (%) (N=18,609)* BENZODIAZEPINES, n (%) (N=4448)* BISPHOSPHONATES, n (%) (N=670)* HYPOGLYCEMICS, n (%) (N=11,294)* LIPID-LOWERING AGENTS, n (%) (N=4980)* Sex • Male 11,623 (31.1) 4596 (32.2) 8463 (45.5) 1414 (31.8) 79 (11.8) 4609 (40.8) 2733 (54.9) • Female 25,779 (68.9) 9661 (67.8) 10,146 (54.5) 3034 (68.2) 591 (88.2) 6685 (59.2) 2247 (45.1) Age group, y • 18-44 14,980 (40.1) 6815 (47.8) 2981 (16.0) 1681 (37.8) 35 (5.2) 3436 (30.4) 394 (7.9) • 45-64 13,421 (35.9) 5179 (36.3) 7912 (42.5) 1774 (39.9) 159 (23.7) 4554 (40.3) 2673 (53.7) • 65-74 4634 (12.4) 1200 (8.4) 3964 (21.3) 579 (13.0) 203 (30.3) 1745 (15.5) 1304 (26.2) • ≥75 4367 (11.7) 1063 (7.5) 3752 (20.2) 414 (9.3) 273 (40.7) 1,559 (13.8) 609 (12.2) Income quintile • Q1 (lowest) 6911 (18.5) 2710 (19.0) 3309 (17.8) 639 (14.4) 135 (20.1) 2045 (18.1) 799 (16.0) • Q2 7083 (18.9) 2845 (20.0) 3453 (18.5) 812 (18.3) 139 (20.7) 2156 (19.1) 969 (19.5) • Q3 7274 (19.4) 2835 (19.9) 3777 (20.3) 878 (19.7) 130 (19.4) 2116 (18.7) 982 (19.7) • Q4 8225 (22.0) 2997 (21.0) 4056 (21.8) 1035 (23.3) 122 (18.2) 2549 (22.6) 1136 (22.8) • Q5 (highest) 6604 (17.7) 2451 (17.2) 3425 (18.4) 940 (21.1) 123 (18.4) 2062 (18.3) 990 (19.9) • Missing 1305 (3.5) 419 (2.9) 589 (3.2) 144 (3.2) 21 (3.1) 366 (3.2) 104 (2.1) ↵* N represents the no. of prescriptions in each grouping.
- Table 3.
Primary nonadherence rates for the study cohorts by medication class, sex, and age group
NONADHERENCE, n (%)* VARIABLE ANTIBIOTICS ANTI-DEPRESSANTS ANTI-HYPERTENSIVES BENZODIAZEPINES BISPHOSPHONATES HYPOGLYCEMICS LIPID-LOWERING AGENTS Total 6552 (17.5) 1956 (13.7) 5634 (30.3) 694 (15.7) 185 (27.6) 881 (21.2) 775 (15.2) Sex • Male 1827 (4.9) 642 (4.5) 2607 (14.0) 220 (5.0) 27 (4.0) 452 (10.9) 408 (8.2) • Female 4725 (12.6) 1314 (9.2) 3027 (16.3) 474 (10.7) 158 (23.6) 429 (10.3) 347 (7.0) Age group, y • 18-44 3070 (8.2) 959 (6.7) 934 (5.0) 232 (5.2) 31 (4.6) 168 (4.0) 62 (1.2) • 45-64 2204 (5.9) 724 (5.1) 2266 (12.2) 293 (6.6) 49 (7.3) 436 (10.5) 342 (6.9) • 65-74 701 (1.9) 152 (1.1) 1244 (6.7) 95 (2.1) 42 (6.3) 186 (4.5) 224 (4.5) • ≥75 577 (1.5) 121 (0.9) 1190 (6.4) 74 (1.7) 63 (9.4) 91 (2.2) 127 (2.6) ↵* N represents the no. of prescriptions in each grouping.
- Table 4.
Primary nonadherence C statistics, ORs, and 95% CIs for patient demographic and clinical characteristics by medication class: Statistically significant differences are presented in boldface.
MEDICATION CLASS VARIABLE ANTIBIOTICS (N=37,402)* ANTIDEPRESSANTS (N=14,257)* ANTI-HYPERTENSIVES (N=18,609)* BENZODIAZEPINES (N=4448)* BISPHOSPHONATES (N=670)* HYPOGLYCEMICS (N=11,294)* LIPID-LOWERING AGENTS (N=4980)* C statistic 0.59 0.56 0.57 0.61 0.69 0.62 0.59 Sex, OR (95% CI) • Male Ref Ref Ref Ref Ref Ref Ref • Female 0.87
(0.82-0.93)0.99
(0.89-1.10)1.08
(1.01-1.15)0.94
(0.78-1.12)0.94
(0.78-1.12)1.23
(1.14-1.33)0.99
(0.84-1.16)Age group, y, OR (95% CI) • 18-44 0.55
(0.49-0.61)0.78
(0.63-0.97)0.93
(0.83-1.04)1.19
(0.87-1.63)0.04
(0.01-1.12)1.29
(1.12-1.47)1.35
(0.96-1.91)• 45-64 0.74
(0.67-0.82)0.79
(0.64-0.98)1.11
(1.02-1.22)1.08
(0.80-1.44)0.69
(0.43-1.12)1.38
(1.22-1.56)1.74
(1.38-2.21)• 65-74 0.81
(0.72-0.91)0.89
(0.69-1.15)1.02
(0.92-1.12)1.14
(0.81-1.60)1.26
(0.49-2.01)1.18
(1.02-1.36)1.26
(0.98-1.61)• ≥75 Ref Ref Ref Ref Ref Ref Ref Income quintile, OR (95% CI) • Q1
(lowest)0.85
(0.78-0.93)1.10
(0.94-1.30)1.23
(1.11-1.37)1.31
(0.98-1.75)1.55
(0.84-2.86)1.12
(0.99-1.28)0.88
(0.68-1.15)• Q2 0.97
(0.89-1.06)1.00
(0.85-1.17)1.15
(1.04-1.27)0.87
(0.68-1.12)1.18
(0.67-2.11)1.11
(0.98-1.26)0.91
(0.71-1.17)• Q3 1.04
(0.95-1.14)0.99
(0.84-1.15)1.32
(1.19-1.46)1.29
(0.99-1.67)1.36
(0.75-2.46)1.13
(1.00-1.29)0.98
(0.76-1.26)• Q4 1.10
(1.00-1.20)1.05
(0.90-1.23)1.14
(1.03-1.25)1.20
(0.93-1.53)1.06
(0.58-1.90)1.02
(0.90-1.15)1.01
(0.79-1.29)• Q5
(highest)Ref Ref Ref Ref Ref Ref Ref • Missing 1.22
(1.03-1.44)1.00
(0.74-1.35)1.05
(0.87-1.27)0.65
(0.42-0.99)1.26
(0.41-3.86)0.89
(0.71-1.12)1.94
(0.95-3.95)No. of hospitalizations† OR (95% CI) • 0 Ref Ref Ref Ref Ref Ref Ref • 1-2 0.99
(0.90-1.09)1.06
(0.90-1.26)1.02
(0.91-1.14)1.40
(1.01-1.93)1.58
(0.87-2.86)0.85
(0.74-0.98)0.96
(0.72-1.29)• ≥3 1.03
(0.77-1.38)0.80
(0.51-1.27)1.03
(0.75-1.40)1.13
(0.44-2.89)0.33
(0.04-2.67)0.77
(0.52-1.13)0.65
(0.28-1.52)No. of ambulatory visits/ OR (95% CI) • 0 Ref Ref Ref Ref Ref Ref Ref • 1-2 1.04
(0.93-1.16)1.17
(0.95-1.43)0.96
(0.81-1.12)1.21
(0.84-1.76)1.12
(0.31-4.07)1.06
(0.88-1.27)1.31
(0.92-1.86)• 3-9 1.09
(0.98-1.22)1.14
(0.94-1.39)0.88
(0.75-1.03)1.13
(0.91-1.85)1.03
(0.30-3.52)0.94
(0.79-1.12)1.34
(0.96-1.88)• ≥10 1.13
(1.00-1.29)1.05
(0.84-1.32)0.89
(0.75-1.05)1.57
(1.04-2.38)1.11
(0.30-4.06)1.03
(0.85-1.25)1.05
(0.71-1.56)No. of ED visits,† OR (95% CI) • 0 Ref Ref Ref Ref Ref Ref Ref • 1-2 0.79
(0.72-0.87)1.01
(0.87-1.18)1.26
(1.12-1.41)1.09
(0.81-1.46)1.57
(0.86-2.86)1.09
(0.96-1.25)1.12
(0.84-1.50)• ≥3 0.61
(0.51-0.72)0.76
(0.58-1.00)1.25
(0.97-1.60)0.93
(0.52-1.65)1.53
(0.51-4.56)0.99
(0.75-1.30)1.92
(0.85-4.34)No. of prescriptions,† OR (95% CI) • 0-2 Ref Ref Ref Ref Ref Ref Ref • 3-5 0.99
(0.92-1.07)1.22
(1.07-1.38)0.75
(0.69-0.82)1.10
(0.89-1.37)0.78
(0.45-1.34)0.96
(0.86-1.07)1.06
(0.86-1.31)• ≥6 0.97
(0.89-1.06)1.42
(1.23-1.65)0.69
(0.63-0.76)1.21
(0.94-1.56)0.65
(0.36-1.15)0.91
(0.81-1.03)1.14
(0.90-1.45)Charlson Comorbidity Index,28 OR (95% CI) • 0 Ref Ref Ref Ref Ref Ref Ref • 1-2 1.20
(1.11-1.29)0.98
(0.86-1.12)1.13
(1.05-1.22)0.80
(0.65-1.00)1.20
(0.77-1.86)0.88
(0.79-0.97)0.91
(0.75-1.09)• ≥3 1.07
(0.91-1.25)0.72
(0.54-0.95)0.99
(0.84-1.15)0.56
(0.34-0.91)1.03
(0.48-2.23)0.71
(0.58-0.88)0.76
(0.52-1.11)
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