Structural and functional support among US older adults with asthma: Cross-Sectional associations with medication adherence

Rachel O'Conor*, Jeni Hebert-Beirne, Mary Jeanne Kwasny, Kamal Eldeirawi, Romana Hasnain-Wynia, Juan Wisnivesky, Michael Wolf, Alex Federman

*Corresponding author for this work

Research output: Contribution to journalArticle

Abstract

Objectives Disadvantaged older adults may benefit from social support in adhering to their medications, but the multidimensional nature of social relationships makes it difficult to identify the most relevant domain. We examined associations of structural and functional support with medication adherence among a cohort of older adults with asthma. Design Cross-sectional analysis of the Asthma Beliefs and Literacy in the Elderly cohort study. Setting Outpatient clinics in New York, New York, and Chicago, Illinois, USA. Participants English-speaking and Spanish-speaking older adults (≥60 years) with asthma. Outcome measures Medication adherence was measured using dose counts from inhaler and self-report. Results Among 383 participants, the mean age was 67 years, 38% identified as Hispanic, 33% identified as black, 52% reported monthly incomes ≤US$1350 and 64% demonstrated poor adherence to their asthma controller medication. Structural and functional support were weakly correlated (r=-0.15, p=0.005). In adjusted analyses, structural support was not associated with medication adherence. Participants who received infrequent functional support in managing their medications had lower odds of poor adherence according to dose counts (OR 0.51, 95% CI 0.26 to 0.98), but not when assessed via self-report (OR 0.81, 95% CI 0.44 to 1.48). Conclusion The receipt of frequent functional support in managing medications was associated with poor adherence to asthma controller medications. Further research is needed to better understand the manner and context which functional support operates in relation to medication adherence among older adults.

Original languageEnglish (US)
Article numbere027430
JournalBMJ open
Volume9
Issue number8
DOIs
StatePublished - Aug 1 2019

Fingerprint

Medication Adherence
Asthma
Self Report
Nebulizers and Vaporizers
Vulnerable Populations
Ambulatory Care Facilities
Hispanic Americans
Social Support
Cohort Studies
Cross-Sectional Studies
Outcome Assessment (Health Care)
Research

Keywords

  • Asthma
  • Geriatrics
  • Health behaviour
  • Psychosocial factors

ASJC Scopus subject areas

  • Medicine(all)

Cite this

O'Conor, Rachel ; Hebert-Beirne, Jeni ; Kwasny, Mary Jeanne ; Eldeirawi, Kamal ; Hasnain-Wynia, Romana ; Wisnivesky, Juan ; Wolf, Michael ; Federman, Alex. / Structural and functional support among US older adults with asthma : Cross-Sectional associations with medication adherence. In: BMJ open. 2019 ; Vol. 9, No. 8.
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title = "Structural and functional support among US older adults with asthma: Cross-Sectional associations with medication adherence",
abstract = "Objectives Disadvantaged older adults may benefit from social support in adhering to their medications, but the multidimensional nature of social relationships makes it difficult to identify the most relevant domain. We examined associations of structural and functional support with medication adherence among a cohort of older adults with asthma. Design Cross-sectional analysis of the Asthma Beliefs and Literacy in the Elderly cohort study. Setting Outpatient clinics in New York, New York, and Chicago, Illinois, USA. Participants English-speaking and Spanish-speaking older adults (≥60 years) with asthma. Outcome measures Medication adherence was measured using dose counts from inhaler and self-report. Results Among 383 participants, the mean age was 67 years, 38{\%} identified as Hispanic, 33{\%} identified as black, 52{\%} reported monthly incomes ≤US$1350 and 64{\%} demonstrated poor adherence to their asthma controller medication. Structural and functional support were weakly correlated (r=-0.15, p=0.005). In adjusted analyses, structural support was not associated with medication adherence. Participants who received infrequent functional support in managing their medications had lower odds of poor adherence according to dose counts (OR 0.51, 95{\%} CI 0.26 to 0.98), but not when assessed via self-report (OR 0.81, 95{\%} CI 0.44 to 1.48). Conclusion The receipt of frequent functional support in managing medications was associated with poor adherence to asthma controller medications. Further research is needed to better understand the manner and context which functional support operates in relation to medication adherence among older adults.",
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Structural and functional support among US older adults with asthma : Cross-Sectional associations with medication adherence. / O'Conor, Rachel; Hebert-Beirne, Jeni; Kwasny, Mary Jeanne; Eldeirawi, Kamal; Hasnain-Wynia, Romana; Wisnivesky, Juan; Wolf, Michael; Federman, Alex.

In: BMJ open, Vol. 9, No. 8, e027430, 01.08.2019.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Structural and functional support among US older adults with asthma

T2 - Cross-Sectional associations with medication adherence

AU - O'Conor, Rachel

AU - Hebert-Beirne, Jeni

AU - Kwasny, Mary Jeanne

AU - Eldeirawi, Kamal

AU - Hasnain-Wynia, Romana

AU - Wisnivesky, Juan

AU - Wolf, Michael

AU - Federman, Alex

PY - 2019/8/1

Y1 - 2019/8/1

N2 - Objectives Disadvantaged older adults may benefit from social support in adhering to their medications, but the multidimensional nature of social relationships makes it difficult to identify the most relevant domain. We examined associations of structural and functional support with medication adherence among a cohort of older adults with asthma. Design Cross-sectional analysis of the Asthma Beliefs and Literacy in the Elderly cohort study. Setting Outpatient clinics in New York, New York, and Chicago, Illinois, USA. Participants English-speaking and Spanish-speaking older adults (≥60 years) with asthma. Outcome measures Medication adherence was measured using dose counts from inhaler and self-report. Results Among 383 participants, the mean age was 67 years, 38% identified as Hispanic, 33% identified as black, 52% reported monthly incomes ≤US$1350 and 64% demonstrated poor adherence to their asthma controller medication. Structural and functional support were weakly correlated (r=-0.15, p=0.005). In adjusted analyses, structural support was not associated with medication adherence. Participants who received infrequent functional support in managing their medications had lower odds of poor adherence according to dose counts (OR 0.51, 95% CI 0.26 to 0.98), but not when assessed via self-report (OR 0.81, 95% CI 0.44 to 1.48). Conclusion The receipt of frequent functional support in managing medications was associated with poor adherence to asthma controller medications. Further research is needed to better understand the manner and context which functional support operates in relation to medication adherence among older adults.

AB - Objectives Disadvantaged older adults may benefit from social support in adhering to their medications, but the multidimensional nature of social relationships makes it difficult to identify the most relevant domain. We examined associations of structural and functional support with medication adherence among a cohort of older adults with asthma. Design Cross-sectional analysis of the Asthma Beliefs and Literacy in the Elderly cohort study. Setting Outpatient clinics in New York, New York, and Chicago, Illinois, USA. Participants English-speaking and Spanish-speaking older adults (≥60 years) with asthma. Outcome measures Medication adherence was measured using dose counts from inhaler and self-report. Results Among 383 participants, the mean age was 67 years, 38% identified as Hispanic, 33% identified as black, 52% reported monthly incomes ≤US$1350 and 64% demonstrated poor adherence to their asthma controller medication. Structural and functional support were weakly correlated (r=-0.15, p=0.005). In adjusted analyses, structural support was not associated with medication adherence. Participants who received infrequent functional support in managing their medications had lower odds of poor adherence according to dose counts (OR 0.51, 95% CI 0.26 to 0.98), but not when assessed via self-report (OR 0.81, 95% CI 0.44 to 1.48). Conclusion The receipt of frequent functional support in managing medications was associated with poor adherence to asthma controller medications. Further research is needed to better understand the manner and context which functional support operates in relation to medication adherence among older adults.

KW - Asthma

KW - Geriatrics

KW - Health behaviour

KW - Psychosocial factors

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U2 - 10.1136/bmjopen-2018-027430

DO - 10.1136/bmjopen-2018-027430

M3 - Article

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SN - 2044-6055

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