Patient-Focused Disaster Preparedness| Volume 336, ISSUE 2, P105-110, August 2008

Download started.


Cohort Study of Medication Adherence in Older Adults (CoSMO): Extended Effects of Hurricane Katrina on Medication Adherence Among Older Adults



      Previous research indicates that many patients with hypertension ran out of medications and had difficulties getting refills immediately after Hurricane Katrina. The extended effect of Hurricane Katrina on antihypertensive medication adherence is not well characterized.


      Data were analyzed for 2194 participants who completed the baseline survey for the Cohort Study of Medication Adherence among Older Adults between August 2006 and September 2007. Based on pre-Katrina zip codes, the study population was categorized into high- and low-affected areas. Low medication adherence was defined as a score less than 6 on the 8-item Morisky Medication Adherence Scale.


      Prevalence of low adherence was similar among participants living in high and low affected areas. Low medication adherence was similar for participants with greater than or less than 25% of the residence damaged by Hurricane Katrina and for participants with and without symptoms of post-traumatic stress disorder. In high affected areas, nonsignificant associations were present for those who had moved since the storm and those with a friend or immediate family member who had died in the month after the storm. These factors were not associated with low medication adherence in low affected areas. In both high- and low-affected areas, lower scores on the hurricane coping self-efficacy scale were associated with low medication adherence (P < 0.05).


      The effect of Hurricane Katrina on patient adherence to antihypertensive medication was limited in the second year after the storm. Intrinsic patient factors, such as low coping self-efficacy, remain important factors associated with low adherence.


      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'


      Subscribe to The American Journal of the Medical Sciences
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect


        • Ford E.S.
        • Mokdad A.H.
        • Link M.W.
        • et al.
        Chronic disease in health emergencies: in the eye of the hurricane.
        Prev Chronic Dis. 2006; 3: A46
        • Krousel-Wood M.A.
        • Islam T.
        • Muntner P.
        • et al.
        Medication adherence in older patients with hypertension after hurricane Katrina: implications for clinical practice and disaster management.
        Am J Med Sci. 2008; 336: 99-104
        • Kessler R.C.
        Hurricane Katrina’s impact on the care of survivors with chronic medical conditions.
        J Gen Intern Med. 2007; 22: 1225-1230
        • Shapinsky A.C.
        • Rapport L.J.
        • Henderson M.J.
        • et al.
        Civilian PTSD scales: relationships with trait characteristics and everyday distress.
        Assessment. 2005; 12: 220-230
        • American Psychiatric Association
        Diagnostic and statistical manual of mental disorders,4th ed. American Psychiatric Association, Washington, DC (WA)1994
        • Benight C.C.
        • Ironson G.
        • Durham R.L.
        Psychometric properties of a hurricane coping self-efficacy measure.
        J Trauma Stress. 1999; 12: 379-386
        • Hyre A.D.
        • Benight C.C.
        • Muntner P.
        • et al.
        Psychometric properties of the Hurricane Coping Self-Efficacy Measure following Hurricane Katrina.
        J Nerv Mental Dis. 2008; 196: 562-566
        • Morisky D.E.
        • Ang A.
        • Krousel-Wood M.A.
        • et al.
        Predictive validity of a medication adherence measure in an outpatient setting.
        J Clin Hypertens. 2008; 10: 348-354
        • Krousel-Wood M.A.
        • Islam T.
        • Morisky D.E.
        • et al.
        Concordance of self-reported medication adherence by pharmacy fill in patients with hypertension, Poster presentation at AHA 48th Annual Conference on Cardiovascular Disease Epidemiology and Prevention, Colorado Springs, Colorado, March 14, Abstract Circulation 20082008 (In press)
        • Jones J.K.
        • Gorkin L.
        • Lian J.F.
        • et al.
        Discontinuation of and changes in treatment after start of new courses of antihypertensive drugs: a study of a United Kingdom population.
        BMJ. 1995; 311: 293-295
        • Conlin P.R.
        • Gerth W.C.
        • Fox J.
        • et al.
        Four-year persistence patterns among patients initiating therapy with the angiotensin II receptor antagonist losartan versus other artihypertensive drug classes.
        Clin Ther. 2001; 23: 1999-2010
        • McCombs J.S.
        • Nichol M.B.
        • Newman C.M.
        • et al.
        The costs of interrupting antihypertensive drug therapy in a Medicaid population.
        Med Care. 1994; 32: 214-226
        • Monane M.
        • Bohn R.L.
        • Gurwitz J.H.
        • et al.
        The effects of initial drug choice and comorbidity on antihypertensive therapy compliance: results from a population-based study in the elderly.
        Am J Hypertens. 1997; 10: 697-704
        • Marentette M.A.
        • Gerth W.C.
        • Billings D.K.
        • et al.
        Antihypertensive persistence and drug class.
        Can J Cardiol. 2002; 18: 649-656
        • Sharkness C.M.
        • Snow D.A.
        The patient’s view of hypertension and compliance.
        Am J Prev Med. 1992; 8: 141-146
        • Wang P.S.
        • Bohn R.L.
        • Knight E.
        • et al.
        Noncompliance with antihypertensive medications: the impact of depressive symptoms and psychosocial factors.
        J Gen Intern Med. 2002; 17: 504-511
        • Krousel-Wood M.
        • Hyre A.
        • Muntner P.
        • et al.
        Methods to improve medication adherence in patients with hypertension: current status and future directions.
        Curr Opin Cardiol. 2005; 20: 296-300