Factors influencing cost-related nonadherence to medication in older adults: a conceptually based approach.

TitleFactors influencing cost-related nonadherence to medication in older adults: a conceptually based approach.
Publication TypeJournal Article
Year of Publication2010
AuthorsZivin, K, Ratliff, S, Heisler, MM, Langa, KM, Piette, JD
JournalValue Health
Volume13
Issue4
Pagination338-45
Date Published2010 Jun-Jul
ISSN Number1524-4733
Call Numbernewpubs20100729_Zivin.pdf
KeywordsAged, Aged, 80 and over, Chronic disease, Female, Financing, Personal, Health Status, Humans, Logistic Models, Male, Medication Adherence, Models, Econometric, Multivariate Analysis, Prescription Fees, Risk Factors, Socioeconomic factors, United States
Abstract

<p><b>OBJECTIVE: </b>Although multiple noncost factors likely influence a patient's propensity to forego treatment in the face of cost pressures, little is known about how patients' sociodemographic characteristics, physical and behavioral health comorbidities, and prescription regimens influence cost-related nonadherence (CRN) to medications. We sought to determine both financial and nonfinancial factors associated with CRN in a nationally representative sample of older adults.</p><p><b>METHODS: </b>We used a conceptual model developed by Piette and colleagues that describes financial and nonfinancial factors that could increase someone's risk of CRN, including income, comorbidities, and medication regimen complexity. We used data from the 2004 wave of the Health and Retirement Study and the 2005 HRS Prescription Drug Study to examine the influence of factors within each of these domains on measures of CRN (including not filling, stopping, or skipping doses) in a nationally representative sample of Americans age 65+ in 2005.</p><p><b>RESULTS: </b>Of the 3071 respondents who met study criteria, 20% reported some form of CRN in 2005. As in prior studies, indicators of financial stress such as higher out-of-pocket payments for medications and lower net worth were significantly associated with CRN in multivariable analyses. Controlling for these economic pressures, relatively younger respondents (ages 65-74) and depressive symptoms were consistent independent risk factors for CRN.</p><p><b>CONCLUSIONS: </b>Noncost factors influenced patients' propensity to forego treatment even in the context of cost concerns. Future research encompassing clinician and health system factors should identify additional determinants of CRN beyond patients' cost pressures.</p>

DOI10.1111/j.1524-4733.2009.00679.x
User Guide Notes

http://www.ncbi.nlm.nih.gov/pubmed/20070641?dopt=Abstract

Endnote Keywords

health Care Costs/socioeconomic Status/cost-related nonadherence/risk factors

Endnote ID

22970

Alternate JournalValue Health
Citation Key7476
PubMed ID20070641
PubMed Central IDPMC3013351
Grant ListU01 AG009740 / AG / NIA NIH HHS / United States
5P60-DK020572 / DK / NIDDK NIH HHS / United States
UL1RR024986 / RR / NCRR NIH HHS / United States
P60 DK020572-28 / DK / NIDDK NIH HHS / United States
U01 AG09740 / AG / NIA NIH HHS / United States
P60 DK020572 / DK / NIDDK NIH HHS / United States
UL1 RR024986-037263 / RR / NCRR NIH HHS / United States
UL1 RR024986 / RR / NCRR NIH HHS / United States