Mhd Wasem Alsabbagh|Mark Lemstra|Dean T. Eurich|Lisa M. Lix|Thomas W. Wilson|Erin Watson|David Blackburn
Socioeconomic Status and Nonadherence to Antihypertensive Drugs: A Systematic Review and Meta-Analysis
University of Saskatchewan|University of Saskatchewan|University of Alberta|University of Manitoba|Royal University Hospital|University of Saskatchewan|University of Saskatchewan
although conventional wisdom suggests low socioeconomic status ses robust predictor medication nonadherence strength association remains unclear1 estimate proportion studies identified ses potential risk indicator nonadherence 2 describe type ses measurements 3 quantify association ses nonadherence antihypertensive pharmacotherapya systematic review metaanalysis research design used searched multiple electronic databases studies english french examining nonadherence antihypertensive medications measured electronic prescription databases explanatory factors considered two authors independently assessed quality described ses measures recorded association nonadherence antihypertensives randomeffects model metaanalysis performed heterogeneity examined using i2 statisticfiftysix studies 4780293 subjects met inclusion criteria twentyfour studies 43 report ses measures reported n 32 seven 13 examined one component none performed multidimensional assessment studies relied income incomerelated measures prescriptiondrug benefits copayments 27 32 84 metaanalysis could quantified 40 cohorts reported 30 studies overall pooled adjusted risk estimate nonadherence according ses high vs low 089 95 confidence interval 087092 i2 95 p 0001 similar patterns observed subgroups examinedpublished studies found strong association low ses nonadherence antihypertensive medications however important limitations assessment ses identified virtually studies future studies required ascertain whether stronger association observed ses determined comprehensive measures