Socioeconomic disadvantage and primary non-adherence with medication

Objective. Lack of adherence with pharmacological therapy is a public health concern that compels tremendous costs for the health care system and the community. To analyse the association between socioeconomic disadvantage and primary non-adherence with medication, and to explore possible mediating effects of trust in health care and lifestyle profile. Design. Cross-sectional population-based study based on data from the Swedish national public health surveys 2004–2005. Participants. The study comprised 13603 men and 18292 women aged 21–84 years who had any contact with a physician at a hospital or primary care centre. Measures. Primary non-adherence with medication based on whether respondents reported that they refrained from purchas-ing at the pharmacy prescribed medication. Socioeconomic Disadvantage Index was based on four different indicators of economic deprivation. Results. Socioeconomic disadvantage was associated with primary non-adherence with medication independent of long-term illness, risky lifestyle, low education, living alone and low trust for health care. This association increased with older age, particu-larly among women. Among individuals aged 21–34 years, severe compared with no socioeconomic disadvantage, was associated with two-fold increased odds for non-adherence with medication. The corresponding odds among individuals aged 65–84 years were three-fold increase among elderly men (OR 3.3, 95 % CI: 1.4–7.8) and six-fold increase among elderly women (OR 6.2, 95 % CI: 2.5–15.3). Yet every seventh elderly woman aged 65–84 years suffered from long-term illness. Conclusions. Results indicate that health policies for ‘care on equal terms ’ in Sweden have been less successful in relation to equitable access to prescribed medication, especially among the elderly