Individual characteristics, area social participation, and primary non-concordance with medication: a multilevel analysis

BMC Public Health. 2006 Mar 2:6:52. doi: 10.1186/1471-2458-6-52.

Abstract

Background: Non-concordance with medication remains a major public health problem that imposes a considerable financial burden on the health care system, and there is still a need for studies on correlates of non-concordance. Our first aim is to analyse whether any of the individual characteristics age, educational level, financial strain, self-rated health, social participation, and trust in the health care system are associated with primary non-concordance with medication. Our second aim is to investigate whether people living in the same area have similar probability of primary non-concordance with medication, that relates to area social participation.

Methods: We analysed cross sectional data from 9,070 women and 6,795 men aged 18 to 79 years, living in 78 areas in central Sweden, who participated in the Life & Health year 2000 survey, with multilevel logistic regression (individuals at the first level and areas at the second level).

Results: Younger age, financial strain, low self-rated health, and low trust in the health care system were associated with primary non-concordance with medication. However, area social participation was not related to primary non-concordance, and the variation in primary non-concordance between the areas was small.

Conclusion: Our results indicate that people in central Sweden with younger age, financial difficulties, low self-rated health, and low trust in the health care system may have a higher probability of primary non-concordance with medication. However, the area of residence--as defined by administrative boundaries--seems to play a minor role for primary non-concordance.

Publication types

  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Adolescent
  • Adult
  • Age Factors
  • Aged
  • Cross-Sectional Studies
  • Delivery of Health Care*
  • Female
  • Humans
  • Logistic Models
  • Male
  • Middle Aged
  • Patient Compliance / psychology*
  • Patient Compliance / statistics & numerical data
  • Self Administration / psychology*
  • Self Administration / statistics & numerical data
  • Social Support*
  • Socioeconomic Factors
  • Sweden
  • Trust*