Among rural older adults, an apparent physical-activity contrast in nonblank medication-field presence was markedly attenuated when chronic-disease management registration was incorporated into the analysis
4 affiliations
- 1School of Wushu, Henan University
- 2Henan University, Institute of Gerontology
- 3School of Physical Education and Health Sciences, Mudanjiang Normal University
- 4Dongcheng Community Health Service Center
Abstract
Background: Medication fields created for chronic-disease management may mislead when reused as medication-exposure measures in broader older-adult populations. Using routine exercise-frequency as routine-recorded physical activity (PA), we compared PA + records (daily, at least weekly, or occasional exercise) with PA− records (no exercise) and examined how nonblank medication-field presence changed after management-registration context was incorporated.
Methods: This cross-sectional study used 2,270 examination records from a 2025 rural primary-care program in northeastern China; PA was available for 2,226 records. The outcome was any nonblank text in the main-medication field. Modified Poisson regression estimated prevalence ratios (PRs) with small-sample-adjusted cluster-robust inference across 20 sites. Sequential models incorporated demographics, site, and four hypertension/diabetes management-registration categories. Logistic regression estimated standardized proportions and absolute differences. Medication text underwent secondary audit, including 200 randomly sampled retained entries independently reviewed by two pharmacists.
Results: Nonblank medication fields occurred in 1,114/1,157 (96.3%) records with hypertension and/or diabetes management registration versus 27/1,113 (2.4%) with neither registration. Field presence was low without registration and near-complete with hypertension-only or dual registration; the diabetes-only stratum was small (n = 37). Overall field presence was 56.4% in PA+ and 42.8% in PA− records (PR 1.317, 95% CI 1.076–1.612). After registration context was incorporated, the PR was 1.001 (95% CI 0.960–1.043); full adjustment yielded 1.002 (95% CI 0.959–1.046). Standardized proportions were 51.26% and 51.14%, a difference of 0.12 percentage points (95% CI −2.07 to 2.30). Among 1,368 retained entries, archived labels classified 75.9% as antihypertensive, 14.5% as glucose-lowering, 0.5% as other cardiovascular, 1.7% as other medications, and 7.4% as unresolved. Inter-reviewer agreement for broad therapeutic class was 99.5% (κ = 0.982), and parser–manual-reference concordance was 99.0%; these assessments did not verify medication exposure.
Conclusion: Nonblank main-medication-field recording was strongly patterned by chronic-disease management registration, and the apparent overall PA-related contrast was markedly attenuated after this context was incorporated. Blank fields cannot establish medication nonuse, and nonblank or consistently parsed text cannot establish complete, current medication exposure.
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BibTeX
@article{xu2026among,
title = {{Among rural older adults, an apparent physical-activity contrast in nonblank medication-field presence was markedly attenuated when chronic-disease management registration was incorporated into the analysis}},
author = {Kun Xu and Yiming Zhang and Yongheng Zhao and Xuefeng Xi and Gaixia Hou and Zhuangzhuang Guo and Limeng Liu and Yajuan Wang and Dehui Zhang},
journal = {Frontiers in Pharmacology},
year = {2026},
month = oct,
doi = {10.3389/fphar.2026.1965382},
url = {https://www.frontiersin.org/articles/10.3389/fphar.2026.1965382/full},
note = {CC BY 4.0},
}
RIS
TY - JOUR
TI - Among rural older adults, an apparent physical-activity contrast in nonblank medication-field presence was markedly attenuated when chronic-disease management registration was incorporated into the analysis
AU - Kun Xu
AU - Yiming Zhang
AU - Yongheng Zhao
AU - Xuefeng Xi
AU - Gaixia Hou
AU - Zhuangzhuang Guo
AU - Limeng Liu
AU - Yajuan Wang
AU - Dehui Zhang
PY - 2026
DA - 2026/10/15
JO - Frontiers in Pharmacology
DO - 10.3389/fphar.2026.1965382
UR - https://www.frontiersin.org/articles/10.3389/fphar.2026.1965382/full
AB - Background: Medication fields created for chronic-disease management may mislead when reused as medication-exposure measures in broader older-adult populations. Using routine exercise-frequency as routine-recorded physical activity (PA), we compared PA + records (daily, at least weekly, or occasional exercise) with PA− records (no exercise) and examined how nonblank medication-field presence changed after management-registration context was incorporated. Methods: This cross-sectional study used 2,270 examination records from a 2025 rural primary-care program in northeastern China; PA was available for 2,226 records. The outcome was any nonblank text in the main-medication field. Modified Poisson regression estimated prevalence ratios (PRs) with small-sample-adjusted cluster-robust inference across 20 sites. Sequential models incorporated demographics, site, and four hypertension/diabetes management-registration categories. Logistic regression estimated standardized proportions and absolute differences. Medication text underwent secondary audit, including 200 randomly sampled retained entries independently reviewed by two pharmacists. Results: Nonblank medication fields occurred in 1,114/1,157 (96.3%) records with hypertension and/or diabetes management registration versus 27/1,113 (2.4%) with neither registration. Field presence was low without registration and near-complete with hypertension-only or dual registration; the diabetes-only stratum was small (n = 37). Overall field presence was 56.4% in PA+ and 42.8% in PA− records (PR 1.317, 95% CI 1.076–1.612). After registration context was incorporated, the PR was 1.001 (95% CI 0.960–1.043); full adjustment yielded 1.002 (95% CI 0.959–1.046). Standardized proportions were 51.26% and 51.14%, a difference of 0.12 percentage points (95% CI −2.07 to 2.30). Among 1,368 retained entries, archived labels classified 75.9% as antihypertensive, 14.5% as glucose-lowering, 0.5% as other cardiovascular, 1.7% as other medications, and 7.4% as unresolved. Inter-reviewer agreement for broad therapeutic class was 99.5% (κ = 0.982), and parser–manual-reference concordance was 99.0%; these assessments did not verify medication exposure. Conclusion: Nonblank main-medication-field recording was strongly patterned by chronic-disease management registration, and the apparent overall PA-related contrast was markedly attenuated after this context was incorporated. Blank fields cannot establish medication nonuse, and nonblank or consistently parsed text cannot establish complete, current medication exposure.
SN - 1663-9812
ER -