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Abstract: TH-PO591

Assessment of Medication Adherence Among Adults with Glomerular Disease

Session Information

Category: Glomerular Diseases

  • 1402 Glomerular Diseases: Clinical, Outcomes, and Trials

Authors

  • Krissberg, Jill, Northwestern University Feinberg School of Medicine, Chicago, Illinois, United States
  • Helmuth, Margaret, Arbor Research Collaborative for Health, Ann Arbor, Michigan, United States
  • Smith, Abigail R., Arbor Research Collaborative for Health, Ann Arbor, Michigan, United States
  • Vasylyeva, Tetyana L., Texas Tech University Health Sciences Center, Lubbock, Texas, United States
  • Robinson, Bruce M., Arbor Research Collaborative for Health, Ann Arbor, Michigan, United States
  • Lafayette, Richard A., Stanford University School of Medicine, Stanford, California, United States
  • Tuttle, Katherine R., University of Washington, Seattle, Washington, United States

Group or Team Name

  • Cure Glomerulonephropathy Network.
Background

Patients with glomerular disease (GD) face challenges taking complex and potentially toxic medication regimens. This study assessed medication adherence in adults with GD and associations with demographic, socioeconomic and disease-related factors.

Methods

CureGN is a multinational prospective cohort study of prevalent patients with biopsy proven GD. Nonadherence is assessed at enrollment and follow-up visits. We compared patient and disease characteristics at enrollment and probability of nonadherence during follow-up across self-reported racial and ethnic groups. We used multivariable mixed effects logistic regression models to explore associations between race and ethnicity and odds of nonadherence, serially adjusting for potential confounders.

Results

In 1,550 adults with GD (66% White, 15% Black, 10% Asian, 9% Hispanic, 56% male, median age 42 years; 64% privately insured (US); at enrollment, median estimated glomerular filtration rate 73.2mL/min/1.73m2, median urine protein-to-creatinine 1.5g/g), 914 (59%) reported at least one non-adherence response over a median 53 (28, 72) months follow-up time where a median 4 (2, 6) surveys were completed. Odds of non-adherence were higher for Black vs. White adults (OR 1.70, 95% CI 1.24-2.33), for public insurance (US) (OR 1.45, 95% CI 1.06-1.98), and for moderate or greater edema (OR 1.45, 95% CI 1.13-1.86). While forgetfulness was the most common stated reason for medication non-adherence (60%), Black adults were most likely to cite side effects (23% for Black adults vs 17% for overall cohort), cost (7% vs 3%), and feeling well (12% vs 8%) as reasons for non-adherence.

Conclusion

Non-adherence to medication is common in adults with GD. Black compared to White adults had higher odds of non-adherence, with side effects, cost, and feeling well all more commonly indicated as reasons. Interventions to target these reasons across racial and ethnic groups may help improve medication adherence.

Figure: Odds ratios with 95% CI bars compared to White adults with sequential adjustment for confounders

Funding

  • NIDDK Support