Evidence map›Paper›PMID 31253498›Full record

ArticleResearch in social & administrative pharmacy : RSAP2020

Environmental and individual predictors of medication adherence among elderly patients with hypertension and chronic kidney disease: A geospatial approach.

Yun Han, Rajiv Saran, Steven R Erickson, Richard A Hirth, Kevin He, Rajesh Balkrishnan

Open access · greenAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Research in social & administrative pharmacy : RSAP, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 18 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
18citing papers in PubMed, 1 pooled it
1.9field-weighted citation impact, top 15% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

18 citing papers in PubMed, 1 synthesis or guideline pooled it, 21 citations in OpenAlex.

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  17. Hypertension and Drug Adherence in the Elderly.Frontiers in cardiovascular medicine · 2020
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

6 authors at 2 institutions in 1 country.

Yun HanDivision of Nephrology, Department of Internal Medicine, University of Michigan, Ann Arbor, MI, USA; Kidney Epidemiology and Cost Center, School of Public Health, University of Michigan, Ann Arbor, MI, USA.
Rajiv SaranDivision of Nephrology, Department of Internal Medicine, University of Michigan, Ann Arbor, MI, USA; Kidney Epidemiology and Cost Center, School of Public Health, University of Michigan, Ann Arbor, MI, USA.
Steven R EricksonUniversity of Michigan, College of Pharmacy, USA.
Richard A HirthKidney Epidemiology and Cost Center, School of Public Health, University of Michigan, Ann Arbor, MI, USA; Department of Health Management and Policy, School of Public Health, University of Michigan, Ann Arbor, MI, USA.
Kevin HeKidney Epidemiology and Cost Center, School of Public Health, University of Michigan, Ann Arbor, MI, USA; Department of Biostatistics, School of Public Health, University of Michigan, Ann Arbor, MI, USA.
Rajesh BalkrishnanUniversity of Virginia School of Medicine, Department of Public Health Sciences, USA. Electronic address: rb9ap@virginia.edu.
University of Michigan–Ann Arbor · USUniversity of Virginia · US

Funding

NLM NIH HHS HHSN276201400001C
6 · The paper itself

Abstract

backgroundFew studies have examined how adherence to antihypertensive medications varies across different regions or how neighborhood-level factors were related to individuals' medication-taking behaviors in patients.

objectiveTo explore local variation in medication adherence and examine environmental and individual influences on adherence to angiotensin-converting enzyme inhibitors (ACEIs) and angiotensin-receptor blockers (ARBs) among elderly hypertensive patients with chronic kidney disease (CKD) in the United States.

methodsThe Medicare 5% sample claim data (2006-2013), American Community Survey 5-Year Data (2005-2009) and the Health Resources and Services Administration Primary Care Service Area data (2007). The primary outcome was medication adherence, measured by Proportion of Days Covered (PDC). Geographically weighted regression (GWR) and linear mixed-effects models were used to investigate the relationship between environmental factors, individual risk factors and medication adherence.

resultsA total of 70,201 hypertensive CKD patients residing in 2,981 counties of the US were selected. Significant spatial autocorrelation was observed in ACEIs/ARBs PDC. The West North Central and New England regions demonstrated higher adherence compared to the East South Central and West South Central regions. Residing in Medically Underserved Areas, counties with high deprivation scores, and not receiving Part D Low-income Subsidy were associated with poor medication adherence.

conclusionsMedication adherence is geographically differentiated across the US. Environmental and individual factors identified may be helpful in the design of local interventions focused on improving patient outcomes from a population perspective.

Indexed as

Diabetes MellitusHypertensionRenal Insufficiency, ChronicAgedAngiotensin-Converting Enzyme InhibitorsAngiotensin Receptor AntagonistsHumansMedicareMedication AdherenceRetrospective StudiesUnited StatesAngiotensin-Converting Enzyme InhibitorsAngiotensin Receptor AntagonistsChronic kidney disease (CKD)EnvironmentGeospatial analysisHypertensionMedication adherence

Identifiers

PMID31253498
PMCPMC6925652
OpenAlexW2952900656

What OpenQuestion holds

Textmetadata
LicenceTDM
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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.