Primary Medication Adherence in a Rural Population: The Role of the Patient-Physician Relationship and Satisfaction with Care

Article Figures & Data

Table 1.

Characteristics of Respondents Who Have Seen a Healthcare Provider in the Last Year* (N = 3926)

Characteristics	N	Percentage
Age
18 to 39 years	1447	36.9
40 to 64 years	1640	41.8
>65 years	839	21.4
Female	2615	66.6
Married	2163	55.1
Race/ethnicity
White	2666	67.9
Black	1115	28.4
Other	90	2.3
Health status
Good—Excellent	2901	73.9
Fair—Poor	1025	26.1
Education
<High school graduate	726	18.5
High school graduate	1590	40.5
College graduate	1610	41.0
Household income
<$14,999	1017	25.9
$15,000-$24,999	612	15.6
$25,000-$49,999	1035	26.4
>$50,000	822	20.9
Work Status
Employed	2510	54.3
Unemployed	312	7.3
Insurance Coverage
Uninsured	891	22.7
Private	1845	47.1
Medicare	836	21.3
Medicaid	212	5.4
Primary medication non–adherence	894	21.6

* Data weighted for county sampling fractions and to adjust demographics to that of the surveyed.

Table 2.

Sociodemographic Factors, Health Status, and Primary Medication Non-adherence (N = 3926)

Variable	Unadjusted Percentage of Primary Non-adherence	Primary Non-adherence, Unadjusted OR (95% CI)	Primary Non-adherence,^* Adjusted OR (95% CI)
Age
18–64 years	24.0	2.27 (1.72–3.03)^‡	2.70 (1.89–3.85)^‡
> 65 years^†	12.2
Gender
Females	24.1	1.44 (1.19–1.74)^‡	1.36 (1.10–1.68)^‡
Males^†	18.1	–	–
Race
African American	22.8	1.50 (0.89–2.53)	1.72 (1.01–2.96)^‡
White^‡	20.6	–	–
Marital Status
Married	21.6	1.00 (0.84–1.19)	1.29 (1.03–1.62)^‡
Single^†	21.6	–	–
Income
<$15,000	28.1	1.88 (1.41–2.49)^‡	2.16 (1.46–3.19)^‡
$15,000-$24,999	25.9	1.68 (1.26–2.23)^‡	1.96 (1.38–2.78)^‡
$25,000-$49,999	19.5	1.16 (0.89–1.53)	1.21 (0.90–1.64)
> $50,000^†	17.2	–	–
Education:
< High School	21.0	1.29 (0.96–1.73)	0.88 (0.61–1.27)
High school	23.4	1.49 (1.17–1.89)^‡	1.18 (0.90–1.56)
College grad^†	17.1	–	–
Employment
Unemployed	31.8	1.75 (1.27–2.43)^‡	1.35 (0.95–1.15)
Employed^†	21.0	–	–
Health Status:
Fair/poor	28.4	1.70 (1.42–2.04)^‡	1.69 (1.35–2.12)^‡
Good/excellent^†	18.9	–	–

* Adjusted for age, sex, marital status, race, education, income, employment, and health status.
† Referent group
‡ Statistically significant odds ratio

Table 3.

Insurance Status, Transportation, and Primary Medication Non-adherence (N = 3926)

Variable	Unadjusted %	Primary Non-adherence, Unadjusted OR (95% CI)	Primary Non-adherence, Adjusted^* OR (95% CI)
Insurance
Uninsured	28.7	1.70 (1.37–2.11)^‡	1.24 (0.95–1.63)
Medicare	19.4	1.01 (0.81–1.28)	1.42 (0.97–2.10)
Medicaid	22.5	1.22 (0.86–1.74)	0.95 (0.59–1.51)
Private^†	19.1	–	–
Ease of traveling to Doctor’s office
Somewhat/ Great problem	36.1	2.32 (1.82–2.94)^‡	1.78 (1.35–2.38)^‡
Not a problem/ Minor problem^†	19.7	–	–

Model P 0.00
* Adjusted for age, sex, marital status, race, education, income, employment, health status
† Referent group
‡ Statistically significant odds ratio

Table 4.

Physician-Patient Relationship Factors, Satisfaction With Care, and Primary Medication Non-adherence (N = 3926)

Variable	Unadjusted % Non-Adherence	Primary Non-Adherence, Unadjusted OR (95% CI)	Primary Non-Adherence, Adjusted^* OR (95% CI)
Regular Source of Care
Yes	21.1	0.77 (0.57–1.05)	1.27 (0.88–1.83)
No^†	25.8	–	–
Confidence in Dr.’s Ability
Somewhat/Not	32.3	2.00 (1.64–2.44) ^‡	1.37 (1.04–1.79)^‡
Mostly/Very^†	19.2	–	–
Satisfaction with Concern Shown
Not satisfied	40.0	2.63 (1.85–3.70) ^‡	1.75 (1.03–3.03) ^‡
Satisfied^†	20.4	–	–
Overall Satisfaction with Care
Not satisfied	36.6	2.27 (1.67–3.03) ^‡	1.33 (0.81–2.17)
Satisfied^†	20.4	–	–
Satisfaction With Getting Questions Answered
Not satisfied	34.8	2.04 (1.45–2.86) ^‡	0.78 (0.45–1.33)
Satisfied^†	20.7	–	–
Satisfaction with Quality of Care Received
Not satisfied	34.4	2.00 (1.43–2.78)^‡	0.72 (0.42–1.23)
Satisfied^†	20.1	–	–
Satisfaction with Office Staff
Not satisfied	36.5	2.22 (1.59–3.03) ^‡	1.56 (1.00–2.38) ^‡
Satisfied^†	20.7	–	–

Model P 0.00
* Adjusted for age, sex, marital status, education, income, employment, health status
† Referent group
‡ Statistically significant odds ratio