The Cohort Study of Medication Adherence among Older Adults
- Grant number: ROI AG022536
- Sponsor: National Institutes of health (NIH) National Institutes on Aging (NIA)
- Principal Investigator: Marie A Krousel-Wood, MD, MSPH
The mission of the Cohort Study of Medication Adherence among Older Adults (CoSMO) is to lay the groundwork for interventions to improve medication adherence and clinical outcomes in older adults with hypertension and will increase our understanding of factors contributing to therapeutic outcomes in the use of medications by these patients.
The goal of Cohort Study of Medication Adherence among Older Adults (CoSMO) with essential hypertension (HTN) in a managed care setting is to investigate the multiple factors that influence antihypertensive medication adherence (via validated self-report and pharmacy fill measures). The specific aims of this cohort study are as follows:
- to assess the impact of psychosocial, behavioral, health, quality of life, sexual function, medication class, and clinical factors measured at baseline on subsequent change in antihypertensive medication adherence over 2 years of follow-up
- to assess health care system issues (perception of primary care provider, satisfaction with access and communication), use of prescribed and over-the-counter and unconventional medications and lifestyle modifications on anti-hypertensive medication adherence and change in adherence
- to determine the relationship of antihypertensive medication adherence at baseline with future medical and psychosocial outcomes such as blood pressure control, cardiovascular disease incidence and all-cause mortality, quality of life, utilization
- to explore differences in aims 1-3 with regards to gender and race.
To address these specific aims, we recruited a random, race-and gender-diverse sample of 2194 HTN patients > 65 years of age who met the study eligibility requirements from the pool of all hypertensive patients enrolled in a large southern managed care organization. We have assessed study participant’s medication adherence, demographic, behavioral, treatment (i.e. medication class), quality of life, duration of hypertension, psycho-social factors and perceptions of primary care provider, and satisfaction with access to care at baseline and after 1 and 2 years of follow-up via telephone-administered surveys.
Rigorous quality control procedures have been implemented to assure high quality data. Blood pressure control, severity of hypertension, cardiovascular outcomes, healthcare utilization at baseline and follow-up have been collected. Models predicting change in medication adherence, blood pressure control, utilization, and cardiovascular events are under development.
- Marie Krousel-Wood, MD, MSPH
- Edward Frohlich, MD
- Elizabeth Holt, PhD
- Donald Morisky , ScD., MSPH, ScM
- Paul Muntner, PhD
- Richard Re, MD
- Larry Webber, PhD
CoSMO Advisory Panel
- Jiang He, MD, PhD
- Paul Whelton, MD