Life events, coping, and antihypertensive medication adherence among older adults: the cohort study of medication adherence among older adults

Abstract

The authors examined the association between life events and antihypertensive medication adherence in older adults and the moderating role of coping. A cross-sectional analysis was conducted by using data (n = 1,817) from the Cohort Study of Medication Adherence among Older Adults (recruitment conducted from August 2006 through September 2007). Life events occurring in the 12 months preceding the study interview were assessed via the Holmes Rahe Social Readjustment Rating Scale (SRRS), and coping levels were assessed via an adapted version of the John Henry Active Coping Scale. Low adherence to antihypertensive medication was defined as scores less than 6 on the 8-item Morisky Medication Adherence Scale (known as "MMAS-8"). Of study participants, 13.2% had low adherence, and 27.2% and 5.0% had medium (150-299) and high (≥300) SRRS scores, respectively. After multivariable adjustment, the odds ratios for low adherence associated with medium and high, versus low, SRRS were 1.50 (95% confidence interval: 1.11, 2.02) and 2.11 (95% confidence interval: 1.24, 3.58), respectively. When multivariable models were stratified by coping level, the association between life events and adherence was evident only among participants with low coping levels.

Figure 1.

Prevalence of total number of life events, stratified by coping level, among CoSMO participants, 2007–2008. Life events over the last year were measured at the 1-year CoSMO follow-up survey by using the Holmes Rahe Social Readjustment Rating Scale (SRRS). Coping was measured at the baseline Cohort Study of Medication Adherence among Older Adults (CoSMO) survey by using a 7-item coping scale: Low and high coping scores are defined as scores above and below the median for the sample, respectively.

Figure 2.

Prevalence of low medication adherence by number of life events, stratified by coping level, among CoSMO participants, 2007–2008. Antihypertensive medication adherence was measured at the 1-year CoSMO follow-up survey by using the 8-item Morisky Medication Adherence Scale (MMAS-8): Low medication adherence was defined as an MMAS-8 score of less than 8. Life events over the last year were measured at the 1-year CoSMO follow-up survey by using the Holmes Rahe Social Readjustment Rating Scale (SRRS). Coping was measured at the baseline Cohort Study of Medication Adherence among Older Adults (CoSMO) survey by using a 7-item coping scale: Low and high coping scores are defined as scores above and below the median for the sample, respectively.