Adults with DD do not use blood pressure medication consistently

By James L. Vacek, MD
Division of Cardiovascular Diseases, School of Medicine, The University of Kansas Medical Center

Adults with developmental disability (DD) have high prevalence of coronary artery disease risk factors and face barriers to optimal diagnosis and disease management.

What did you do in your research?
There were 3,079 eligible individuals, from Kansas, ages 18-64 with DD during the study period. In addition, these individuals were on Medicaid only (not dually eligible for Medicare). However, our sample only included the 280 adults (9%) with DD who had Medicaid claims filed for hypertension from 7/1/05 to 8/31/06. We also reviewed their prescription records of medication use and adherence to medication protocol from 9/1/06 to 8/31/07. Antihypertensive (blood pressure lowering) medication adherence was calculated as the proportion of days covered (PDC). The PDC shows the number of days out of the year that an individual had access to at least one (out of four) types of medications as well as the particular medication class.

What did you find out?
Of the original sample of 3,079 eligible individuals, 9% (n=280) of these adults had hypertension and of these individuals 72% (n=201) submitted claims for antihypertensive medications. Of those having claims submitted, only 50% (n=100) had a PDC rate greater or equal to 80% for the year. A substantial proportion of adults had inconsistent medication use, which may indicate suboptimal therapy. An association was present between younger ages and higher adherence, which may reflect better community-based support for younger adults.

What are the take-home messages?
Barriers to optimal care for this vulnerable population should be identified and addressed.

To learn more about these findings contact Theresa Shireman.

Full Journal Article
Vacek, J.L., Hunt, S.L., & Shireman, T. (2013). Hypertension medication use and adherence among adults with developmental disability. Disability and Health Journal, 6(4), 297-302.