Open Access Research article

Individual characteristics, area social participation, and primary non-concordance with medication: a multilevel analysis

Kristina Johnell1*, Martin Lindström2, Jan Sundquist1, Charli Eriksson3 and Juan Merlo2

Author Affiliations

1 Centre for Family Medicine, Karolinska Institutet, Stockholm, Sweden

2 Community Medicine (Dept Clin Sci), Malmö University Hospital, Faculty of Medicine, Lund University, Sweden

3 Department of Community Medicine and Public Health, Regional Medical Centre, Örebro, Sweden

For all author emails, please log on.

BMC Public Health 2006, 6:52  doi:10.1186/1471-2458-6-52

Published: 2 March 2006

Abstract

Background

Non-concordance with medication remains a major public health problem that imposes a considerable financial burden on the health care system, and there is still a need for studies on correlates of non-concordance. Our first aim is to analyse whether any of the individual characteristics age, educational level, financial strain, self-rated health, social participation, and trust in the health care system are associated with primary non-concordance with medication. Our second aim is to investigate whether people living in the same area have similar probability of primary non-concordance with medication, that relates to area social participation.

Methods

We analysed cross sectional data from 9 070 women and 6 795 men aged 18 to 79 years, living in 78 areas in central Sweden, who participated in the Life & Health year 2000 survey, with multilevel logistic regression (individuals at the first level and areas at the second level).

Results

Younger age, financial strain, low self-rated health, and low trust in the health care system were associated with primary non-concordance with medication. However, area social participation was not related to primary non-concordance, and the variation in primary non-concordance between the areas was small.

Conclusion

Our results indicate that people in central Sweden with younger age, financial difficulties, low self-rated health, and low trust in the health care system may have a higher probability of primary non-concordance with medication. However, the area of residence – as defined by administrative boundaries – seems to play a minor role for primary non-concordance.