Document Detail

Cost-related nonadherence by medication type among Medicare Part D beneficiaries with diabetes.
MedLine Citation:
PMID:  23032359     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: Despite the rollout of Medicare Part D, cost-related nonadherence (CRN) among older adults remains a problem.
OBJECTIVES: To examine the rate and correlates of self-reported CRN among a population of older persons with diabetes.
RESEARCH DESIGN: Cross-sectional.
SUBJECTS: A total of 1264 Part D patients with diabetes, who entered the coverage gap in 2006.
MEASURES: Initial administrative medication lists were verified in computer-assisted telephone interviews, in which participants brought their medication bottles to the phone. Medications were classified into cardiometabolic (diabetes, hypertension, cholesterol-lowering), symptom relief, and "other." Participants were asked if they had any CRN during 2006, and if so to which medication/s. We used the person-medication dyad as the unit of analysis, and tested a multivariate random effects logistic regression model to analyze the correlates of CRN.
RESULTS: Approximately 16% of participants reported CRN. CRN was more frequent for cholesterol-lowering medications (relative risk, 1.54; 95% confidence interval, 1.01-2.32) compared with medications taken for symptom relief. CRN was reported less frequently with increasing age above 75 years, compared with patients between 65 and 69. In addition, compared with those with incomes of ≥$40,000, CRN risk for those with incomes of <$25,000 was markedly higher (relative risk, 3.05; 95% confidence interval, 1.99-4.65).
CONCLUSIONS: In summary, we found high rates of CRN among Medicare beneficiaries with diabetes, particularly those with lower incomes. We observed more frequent CRN for cholesterol-lowering medications as compared with medications for symptom relief. Efforts to ensure medication affordability for this population will be important in boosting adherence to key medications.
Jessica Williams; William N Steers; Susan L Ettner; Carol M Mangione; Obidiugwu K Duru
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Publication Detail:
Type:  Journal Article; Multicenter Study    
Journal Detail:
Title:  Medical care     Volume:  51     ISSN:  1537-1948     ISO Abbreviation:  Med Care     Publication Date:  2013 Feb 
Date Detail:
Created Date:  2013-01-21     Completed Date:  2013-03-14     Revised Date:  2014-09-24    
Medline Journal Info:
Nlm Unique ID:  0230027     Medline TA:  Med Care     Country:  United States    
Other Details:
Languages:  eng     Pagination:  193-8     Citation Subset:  IM    
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MeSH Terms
Age Factors
Cross-Sectional Studies
Diabetes Mellitus / drug therapy*
Hypoglycemic Agents / economics*
Hypolipidemic Agents / economics*
Interviews as Topic
Medicare Part D*
Medication Adherence / statistics & numerical data*
Middle Aged
Risk Factors
United States
Grant Support
Reg. No./Substance:
0/Hypoglycemic Agents; 0/Hypolipidemic Agents

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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