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Using Quantile Regression to Assess Disparities in Medication Adherence

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Objective: To examine racial/ethnic disparities in medication adherence between Asian and Pacific Islander Americans and Whites. Methods: This retrospective data analysis included diabetes patients enrolled in a health plan in Hawaii (N = 43,445). For anti-diabetic, lipid-lowering, and anti-hypertensive medications, quantile regression was estimated at 25th, 50th, and 75th quantiles to examine the association with race and ethnicity, controlling for other patient characteristics. Results: Consistently, Filipinos, Native Hawaiians, and other Pacific Islanders were significantly less adherent than Whites. The greatest disparities were found for other Pacific Islanders using lipid-lowering medications, with adjusted differences in medication adherence, with reductions relative to Whites of as much as 19% for lipid-lowering medications for the 25th quantile of adherence. Conclusion: Whereas the large sample size undoubtedly contributed to the statistical significance, the large magnitude of the disparities, particularly for Filipinos, Native Hawaiians, and other Pacific Islanders, which suggests that these are meaningful differences that need to be addressed. The largest disparities were found at the lowest quantile suggests that they may be occurring among the most vulnerable populations with potentially poor access to care.
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Document Type: Research Article

Affiliations: 1: College of Pharmacy, University of Hawaii, Hilo, HI, USA. [email protected] 2: College of Pharmacy, University of Hawaii, Hilo, HI, USA 3: Department of Native Hawaiian Health, John A. Burns School of Medicine, University of Hawaii, Honolulu, HI, USA

Publication date: January 1, 2014

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  • The American Journal of Health Behavior seeks to improve the quality of life through multidisciplinary health efforts in fostering a better understanding of the multidimensional nature of both individuals and social systems as they relate to health behaviors.

    The Journal aims to provide a comprehensive understanding of the impact of personal attributes, personality characteristics, behavior patterns, social structure, and processes on health maintenance, health restoration, and health improvement; to disseminate knowledge of holistic, multidisciplinary approaches to designing and implementing effective health programs; and to showcase health behavior analysis skills that have been proven to affect health improvement and recovery.

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