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Obesity Modifies the Association of Race/Ethnicity with Medication Adherence in the CARDIA Study

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Abstract

Objective: To assess associations between race/ethnicity and medication adherence, and the potential modifying effects of weight category (normal, overweight, obese) in a community-based sample.

Study design and setting: We studied 1355 participants from the CARDIA (Coronary Artery Risk Development in Young Adults) study who were taking prescription medications in 2000-1. Medication adherence, as rated on the four-item Morisky medication adherence scale (score of 4 = maximum adherence), was reported for all participants.

Results: The mean age ± SD of participants was 40 ± 3.6 years; 45% were African American and 36% were male. Overall, Whites had a higher proportion of maximum adherence than African Americans (59 vs 41%, respectively; p = 0.001). However, this difference was statistically significant only for participants within the normal weight category, of whom 54% of Whites were maximally adherent versus 35% of African Americans (p < 0.05). After adjustment for possible confounding covariates, race/ethnicity was associated with adherence only in those of normal weight: the odds ratio for maximum adherence in Whites versus African Americans of normal weight was 1.98 (95% CI 1.13, 3.47). Within race/ethnicity subgroups, weight category was associated with adherence in Whites but not in African Americans.

Conclusion: Weight category modifies the association of race/ethnicity with medication adherence. The high levels of non-adherence observed among African Americans and obese and overweight Whites bodes poorly for treatment of obesity-associated diseases such as cardiovascular disease or diabetes mellitus.

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Acknowledgements

Work on this manuscript was supported (or partially supported) by contracts from the University of Alabama at Birmingham, Coordinating Center, N01-HC-95095; University of Alabama at Birmingham, Field Center, N01-HC-48047; University of Minnesota, Field Center, N01-HC-48048; Northwestern University, Field Center, N01-HC-48049; Kaiser Foundation Research Institute, N01-HC-48050; University of California, Irvine, Echocardiography Reading Center, N01-HC-45134; Harbor-UCLA Research Education Institute, Computed Tomography Reading Center, N01-HC-05-187; and the National Heart, Lung and Blood Institute.

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Authors and Affiliations

  1. Division of Preventive Medicine, University of Alabama at Birmingham, 1530 3rd Avenue South MT 644, Birmingham, Alabama, 35294-4410, USA

    Maribel Salas, Catarina I. Kiefe, Yongin Kim, Lucia Juarez, Sharina D. Person & O. Dale Williams

  2. Division of Epidemiology & Community Health, University of Minnesota, Minneapolis, Minnesota, USA

    Pamela J. Schreiner

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  1. Maribel Salas
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  2. Catarina I. Kiefe
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Correspondence to Maribel Salas.

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Salas, M., Kiefe, C.I., Schreiner, P.J. et al. Obesity Modifies the Association of Race/Ethnicity with Medication Adherence in the CARDIA Study. Patient-Patient-Centered-Outcome-Res 1, 41–54 (2008). https://doi.org/10.2165/01312067-200801010-00007

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