Anti-Hypertensive Medication Use and Factors Related to Adherence Among Adults With Intellectual and Developmental Disabilities.
Alissa C Cyrus, Julie Royer, Dianna D Carroll and 3 others
PMID 31026202WHAT IT FOUND
49.5% of 1,573 adults with intellectual and developmental disabilities had blood pressure prescriptions on hand for at least 80% of days.
Supervised living, Medicaid waiver services, and primary care visits were linked with better adherence.
Key findings
0149.5% of the 1,573 adults in the adherence cohort reached the 80% adherence threshold.
02Living in community-based settings (aOR 4.20) or nursing home or intermediate care facilities (aOR 5.49) was associated with higher adjusted odds of adherence.
03Black/African American members (aOR 0.68), members receiving SNAP (aOR 0.74), and members with mental health or substance use comorbidity (aOR 0.72) were less likely to be adherent in adjusted analysis.
STILL TO COME
How it was doneWhat they foundWhat it means for OTs
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What it does not show
The study used administrative claims data, so it did not measure blood pressure or whether blood pressure was controlled. The adherence measure showed whether prescriptions were on hand for at least 80% of days, not whether the medication was taken as prescribed. Adherence was measured only in the year after the first anti-hypertensive prescription, so it may not reflect later years. Results come from South Carolina Medicaid adults with IDD, so they may not apply to other areas, non-Medicaid groups, or other disability types. The analysis did not examine adherence by specific IDD type. The study excluded people with dual coverage, pregnancy, end-stage renal disease, or organ transplant, so it does not speak to those groups.
Declared interests
The authors declared no conflicts of interest.
The easy way to misread this
Do not conclude that moving someone to supervised housing or adding waiver services will improve adherence. The study compared existing groups in claims data and found associations; it did not test these supports or measure whether medication was actually taken.