Association of Hispanic ethnicity and linguistic acculturation with cardiovascular medication adherence in patients with suspected acute coronary syndrome.
Association of Hispanic ethnicity and linguistic acculturation with cardiovascular medication adherence in patients with suspected acute coronary syndrome.
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DOI：
10.1016/j.pmedr.2021.101455
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发表时间：
2021-09
影响因子：
2.8
通讯作者：
Kronish IM
中科院分区：
文献类型：
--
作者：
Liyanage-Don NA;Cornelius T;Romero EK;Alcántara C;Kronish IM
尽管心血管疾病（CVD）危险因素的患病率较高，但西班牙裔美国人的CVD相关和全因死亡率较低，预期寿命也高于非西班牙裔白人-这一现象被称为西班牙裔健康悖论。然而，这种生存益处随着对西方生活方式的文化适应的增加而减弱，这可能是由于采取了不健康的行为。因此，我们评估了西班牙裔种族和语言文化适应（以英语水平为衡量标准）是否与心血管药物的不依从性相关。我们招募了2014年5月至2017年11月期间因疑似急性冠状动脉综合征到学术医疗中心急诊科就诊的患者。种族，母语和英语水平是自我报告的。心血管药物的依从性通过记录每次开瓶日期和时间的电子药瓶进行评估。使用具有logit链接的广义线性模型来检查西班牙裔种族和英语水平与每日心血管药物依从性的相关性，调整人口统计学，合并症和电子监测药物的给药频率。在纳入的332例患者中，平均年龄为61.68 ± 12.05岁，43.07%为女性，62.95%为西班牙裔，其中80.38%为母语为西班牙语者。总体而言，西班牙裔患者的药物依从性比非西班牙裔患者高（调整后OR 1.31，95% CI 1.16-1.49，p < 0.001）。然而，在以西班牙语为母语的西班牙裔中，英语水平越高，药物依从性的几率越低（英语水平每提高1分，调整后OR为0.80，95% CI为0.75-0.86，p < 0.001）。虽然西班牙裔有更好的药物依从性比非西班牙裔整体，增加母语西班牙语的人之间的语言涵化与更差的依从性行为。
Despite a higher prevalence of cardiovascular disease (CVD) risk factors, Hispanic-Americans have lower rates of CVD-related and all-cause mortality, as well as higher life expectancy than non-Hispanic whites – a phenomenon known as the Hispanic health paradox. However, this survival benefit attenuates with increased acculturation to Western lifestyles, potentially due to adoption of unhealthy behaviors. Accordingly, we assessed whether Hispanic ethnicity and linguistic acculturation, as measured by English proficiency, were associated with nonadherence to cardiovascular medications. We enrolled patients presenting to an academic medical center emergency department with suspected acute coronary syndrome between May 2014 and November 2017. Ethnicity, native language, and English proficiency were self-reported. Cardiovascular medication adherence was assessed using an electronic pill bottle that recorded the date and time of each bottle opening. Generalized linear models with a logit link were used to examine the association of Hispanic ethnicity and English proficiency with daily cardiovascular medication adherence, adjusting for demographics, comorbidities, and dosing frequency of the electronically-monitored medication. Among 332 included patients, mean age was 61.68 ± 12.05 years, 43.07% were women, and 62.95% were Hispanic, of whom 80.38% were native Spanish-speakers. Overall, Hispanics had higher odds of medication adherence than non-Hispanics (adjusted OR 1.31, 95% CI 1.16–1.49, p < 0.001). However, among native Spanish-speaking Hispanics, greater English proficiency was associated with lower odds of medication adherence (adjusted OR 0.80 per 1-point increase in English proficiency, 95% CI 0.75–0.86, p < 0.001). Although Hispanics had better medication adherence than non-Hispanics overall, increased linguistic acculturation among native Spanish-speakers was associated with worse adherence behaviors.
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影响因子：
8
作者：
Cortes-Bergoderi, Mery;Goel, Kashish;Lopez-Jimenez, Francisco
通讯作者：
Lopez-Jimenez, Francisco
影响因子：
6.3
作者：
Holmes HM;Luo R;Hanlon JT;Elting LS;Suarez-Almazor M;Goodwin JS
通讯作者：
Goodwin JS
影响因子：
39
作者：
Fernandez, Alicia;Quan, Judy;Karter, Andrew J.
通讯作者：
Karter, Andrew J.
影响因子：
12.7
作者：
Arias, Elizabeth;Eschbach, Karl;Sortie, Paul D.
通讯作者：
Sortie, Paul D.
影响因子：
5.4
作者：
Abraído-Lanza, AF;Chao, MT;Flórez, KR
通讯作者：
Flórez, KR