scholarly journals Cost-related Medication Nonadherence in Older Patients with Rheumatoid Arthritis

2013 ◽  
Vol 40 (2) ◽  
pp. 137-143 ◽  
Author(s):  
LESLIE R. HARROLD ◽  
BECKY A. BRIESACHER ◽  
DAN PETERSON ◽  
ASHLEY BEARD ◽  
JEANNE MADDEN ◽  
...  
Keyword(s):  
Rheumatoid Arthritis ◽  
Older Adults ◽  
Basic Needs ◽  
Fold Increase ◽  
Prescription Drug Coverage ◽  
Medication Nonadherence ◽  
Medicare Current Beneficiary Survey ◽  
High Prevalence ◽  
Nationally Representative ◽  
Weighted Prevalence

Objective.Economic access to costly medications including biologic agents can be challenging. Our objective was to examine whether patients with rheumatoid arthritis (RA) are at particular risk for cost-related medication nonadherence (CRN) and spending less on basic needs.Methods.We identified a nationally representative sample of older adults with RA (n = 1100) in the Medicare Current Beneficiary Survey (2004–2008) and compared them to older adults with other morbidities categorized by chronic disease count: 0 (n = 5898), 1–2 (n = 30,538), and ≥ 3 (n = 34,837). We compared annual rates of self-reported CRN (skipping or reducing medication doses or not obtaining prescriptions because of cost) as well as spending less on basic needs to afford medications and tested for differences using survey-weighted logistic regression analyses adjusted for demographic characteristics, health status, and prescription drug coverage.Results.In the RA sample, the unadjusted weighted prevalence of CRN ranged from 20.7% in 2004 to 18.4% in 2008 as compared to 18.5% and 11.9%, respectively, in patients with 3 or more non-RA conditions. In adjusted analyses, having RA was associated with a 3.5-fold increase in the risk of CRN (OR 3.52, 95% CI 2.63–4.71) and almost a 2.5-fold risk of spending less on basic needs (OR 2.41, 95% CI 1.78–3.25) as compared to those without a chronic condition.Conclusion.Patients with RA experience a high prevalence of CRN and forgoing of basic needs, more than do older adults with multiple other chronic conditions. The situation did not improve during a period of policy change aimed at alleviating high drug costs.

scholarly journals Validation of Self‐Reported Rheumatoid Arthritis Using Medicare Claims: A Nationally Representative Longitudinal Study of Older Adults

2021 ◽  
Vol 3 (4) ◽  
pp. 239-249
Author(s):  
Michael J. Booth ◽  
Daniel Clauw ◽  
Mary R. Janevic ◽  
Lindsay C. Kobayashi ◽  
John D. Piette
Keyword(s):  
Rheumatoid Arthritis ◽  
Older Adults ◽  
Longitudinal Study ◽  
Medicare Claims ◽  
Nationally Representative

Cost‐Related Medication Nonadherence Among Older Adults: Findings From a Nationally Representative Sample

2019 ◽  
Vol 67 (12) ◽  
pp. 2463-2473 ◽  
Author(s):  
Green C. Chung ◽  
Richard A. Marottoli ◽  
Leo M. Cooney ◽  
Taeho Greg Rhee
Keyword(s):  
Older Adults ◽  
Representative Sample ◽  
Medication Nonadherence ◽  
Nationally Representative

scholarly journals Cost Reduction Behaviors and Cost-Related Medication Nonadherence in Older Adults with Atrial Fibrillation

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. 615-615
Author(s):  
Benita Bamgbade ◽  
David McManus ◽  
Becky Briesacher ◽  
Darleen Lessard ◽  
Jordy Mehawej ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Older Adults ◽  
Cost Reduction ◽  
Basic Needs ◽  
Medication Nonadherence ◽  
Chi Square ◽  
Assistance Programs ◽  
Systematic Assessment ◽  
Medication Therapy ◽  
Additional Support

Abstract While factors such as forgetfulness may result in medication nonadherence, 2.7 million older adults in the US experience cost-related nonadherence (CRN). Limited research has explored CRN and associated cost-reduction behaviors (CRB) in older adults with atrial fibrillation. The objectives of this study were to 1) describe the prevalence of CRN, CRB and spending less on basic needs to afford medication and 2) examine factors associated with CRB among older adults with atrial fibrillation. Data were drawn from the Systematic Assessment of Geriatric Elements in Atrial Fibrillation (SAGE-AF), a prospective cohort of older adults with atrial fibrillation (>65 years). Using a self-administered survey, all participants completed a validated CRN measure. Chi-square and t-tests were used to evaluate differences in participant characteristics across CRB and significant characteristics (p<0.05) were entered into a logistic regression model. Participants (N=1244) were on average 76 years and 49% were female. Among all participants, 4.2% reported CRN; 69.1% reported CRB; and 5.9% reported spending less on basic needs. Compared to participants who did not engage in CRB, participants who engaged in CRB were less likely to be cognitively impaired and more likely to be a race/ethnicity other than non-Hispanic white; have Medicare insurance; and have comorbidities. CRB were common among older adults with atrial fibrillation and was associated with in-tact cognitive function, the presence of medical comorbidities and non-White race. Clinicians might consider providing patients with cognitive impairment additional support such as patient assistance programs or referrals to pharmacists for medication therapy management to assist with CRB.

scholarly journals No association between rheumatoid arthritis and cognitive impairment in a cross-sectional national sample of older U.S. adults

2021 ◽  
Vol 5 (1) ◽  
Author(s):  
Michael J. Booth ◽  
Mary R. Janevic ◽  
Lindsay C. Kobayashi ◽  
Daniel J. Clauw ◽  
John D. Piette
Keyword(s):  
Rheumatoid Arthritis ◽  
Older Adults ◽  
Cognitive Impairment ◽  
National Sample ◽  
Cognitive Status ◽  
Neuropsychological Battery ◽  
Cross Sectional ◽  
Icd 10 ◽  
Nationally Representative ◽  
National Probability Sample

Abstract Background Studies suggest an increased prevalence of cognitive impairment (CI) among people with rheumatoid arthritis (RA). However, most prior studies have used convenience samples which are subject to selection biases or have failed to adjust for key confounding variables. We thus examined the association between CI and RA in a large national probability sample of older US adults. Methods Data were from interviews with 4462 participants in the 2016 wave of the nationally representative U.S. Health and Retirement Study with linked Medicare claims. RA diagnoses were identified via a minimum of two ICD-9CM or ICD-10 codes in Medicare billing records during the prior 2 years. The Langa-Weir Classification was used to classify cognitive status as normal, cognitively impaired non-dementia (CIND), or dementia based on a brief neuropsychological battery for self-respondents and informant reports for proxy respondents. We compared the odds of CI between older adults with and without RA using logistic regression, adjusted for age, education, gender, and race. Results Medicare records identified a 3.36% prevalence of RA (150/4462). While age, gender, education, and race independently predicted CI status, controlling for these covariates we found no difference in CI prevalence according to RA status (prevalent CI in 36.7% of older adults with RA vs. 34.0% without RA; adjusted OR = 1.08, 95% CI 0.74–1.59, p = .69). Conclusion There was no association between RA and CI in this national sample of older U.S. adults.

Spontaneous self-affirmation before and during COVID-19: Associations with information-seeking, worry and adherence

2020 ◽  
Author(s):  
Tracy Epton ◽  
Chris Keyworth ◽  
Chris Armitage
Keyword(s):  
Older Adults ◽  
Opposite Direction ◽  
Information Seeking ◽  
Demographic Characteristics ◽  
Brief Interventions ◽  
Adaptive Behaviors ◽  
Uk Government ◽  
Nationally Representative

Objective: To assess the extent of spontaneous self-affirmation pre COVID-19 and during COVID-19 pandemic to identify for whom self-affirmation interventions might be helpful; and the extent to which spontaneous self-affirmation is associated with increased information-seeking, worry and adherence to UK government instructions. Methods: Two large nationally-representative surveys of UK adults were conducted via YouGov in March 2019 (pre COVID-19; N = 10421) and April 2020 (during COVID-19; N = 2252); both surveys measured demographic characteristics and spontaneous self-affirmation. The latter survey included measures of time spent accessing COVID-19 related news, worry about COVID-19 related news and degree of adherence to UK government instructions. Results: Spontaneous self-affirmation was lower before COVID-19 (44%) than it was during the pandemic (57%), although the pattern was in the opposite direction among older adults. Older adults were more likely to spontaneously self-affirm during COVID-19 than pre COVID-19. Greater spontaneous self-affirmation was associated with more time spent accessing news, and greater adherence to UK government instructions, but not media-related worry. Conclusions: The threat of COVID-19 may have triggered greater levels of spontaneous self-affirmation, which could give people the resources they needed to allow them to seek COVID-19-related news and adhere to UK government instructions. Groups lower in spontaneous self-affirmation, such as younger people could be targeted with brief interventions to promote self-affirmation and encourage performance of adaptive behaviors.

scholarly journals Longitudinal relationship of diabetes and depressive symptoms in older adults from Mexico: a secondary data analysis

2020 ◽  
Vol 8 (2) ◽  
pp. e001789
Author(s):  
Teresa Alvarez-Cisneros ◽  
Paloma Roa-Rojas ◽  
Carmen Garcia-Peña
Keyword(s):  
Risk Factors ◽  
Older Adults ◽  
Depressive Symptoms ◽  
Secondary Data ◽  
Random Effects Models ◽  
Health Factors ◽  
Longitudinal Association ◽  
Common Risk Factors ◽  
Nationally Representative ◽  
Relationship Of

IntroductionSeveral studies have argued a causal relationship between diabetes and depression, while others have highlighted that their association is a result of common risk factors. Because Mexico is a country with a high prevalence of diabetes, and diabetes and depression are a frequent comorbidity, we chose this country to investigate the longitudinal relationship of these two conditions, focusing on the influence of demographic, health, and socioeconomic factors which could act as common risk factors for both conditions.Research design and methodsUsing the harmonized Mexican Health and Aging Study, a nationally representative sample of adults older than 50 with a response rate of 93%, we analyzed the longitudinal relationship of diabetes and depressive symptoms using ‘between-within’ random-effects models, focusing on the effect of demographic, socioeconomic and health factors.ResultsWhile older adults with diabetes reported a higher prevalence of depressive symptoms in the four waves of the study, there was no causal longitudinal association between them once controlling for demographic, socioeconomic and health factors (between-effect OR=0.88, 95% CI 0.77 to 1.01; within-effect OR=0.87, 95% CI 0.69 to 1.11).ConclusionsThere is no causal longitudinal association between diabetes and depression; the higher prevalence of depression among older adults with diabetes seems a result of socioeconomic and health factors that are not exclusive to respondents with diabetes but are more frequent in this group. Our results highlight the importance of prevention and control of chronic conditions as well as the role of socioeconomic inequalities in mental health.

scholarly journals Association of self-perceived income sufficiency with cognitive impairment among older adults: a population-based study in India

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
T. Muhammad ◽  
Shobhit Srivastava ◽  
T. V. Sekher
Keyword(s):  
Risk Factors ◽  
Older Adults ◽  
Cognitive Impairment ◽  
Activities Of Daily Living ◽  
Psychological Health ◽  
Daily Living ◽  
Basic Needs ◽  
Well Being ◽  
Asset Ownership ◽  
Increased Risk

Abstract Background Greater cognitive performance has been shown to be associated with better mental and physical health and lower mortality. The present study contributes to the existing literature on the linkages of self-perceived income sufficiency and cognitive impairment. Study also provides additional insights on other socioeconomic and health-related variables that are associated with cognitive impairment in older ages. Methods Data for this study is derived from the 'Building Knowledge Base on Population Ageing in India'. The final sample size for the analysis after removing missing cases was 9176 older adults. Descriptive along with bivariate analyses were presented to show the plausible associations of cognitive impairment with potential risk factors using the chi-square test. Also, binary logistic regression analysis was performed to provide the relationship between cognitive impairment and risk factors. The software used was STATA 14. Results About 43% of older adults reported that they had no source of income and 7.2% had income but not sufficient to fulfil their basic needs. Older adults with income but partially sufficient to fulfil their basic needs had 39% significantly higher likelihood to suffer from cognitive impairment than older adults who had sufficient income [OR: 1.39; OR: 1.21–1.59]. Likelihood of cognitive impairment was low among older adults with asset ownership than older adults with no asset ownership [OR: 0.83; CI: 0.72–0.95]. Again, older adults who work by compulsion (73.3%) or felt mental or physical stress due to work (57.6%) had highest percentage of cognitive impairment. Moreover, older adults with poor self-rated health, low instrumental activities of daily living, low activities of daily living, low subjective well-being and low psychological health were at increased risk for cognitive impairment. Conclusion The study highlights the pressing need for care and support and especially financial incentives in the old age to preserve cognitive health. Further, while planning geriatric health care for older adults in India, priority must be given to financially backward, with no asset ownership, with poor health status, older-older, widowed, and illiterate older individuals, as they are more vulnerable to cognitive impairment.

scholarly journals The Relationship Between the Home Environment and Falls for Older Adults With Visual Impairments

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 770-770
Author(s):  
Bonnielin Swenor ◽  
Aleksandra Mihailovic ◽  
Pradeep Ramulu
Keyword(s):  
Older Adults ◽  
Home Environment ◽  
Visually Impaired ◽  
Visual Impairments ◽  
Fold Increase ◽  
Engineering Society ◽  
Environment Assessment ◽  
Risk Factors For Falls ◽  
The Relationship

Abstract The home environment and features of the home have been identified as important risk factors for falls, and may pose particular risk for older adults with visual impairments given difficulty with hazard perception. We used data from 245 participants in the Falls in Glaucoma Study [mean age: 71 years, mean follow-up: 31 months] with homes graded using our previously validated Home Environment Assessment for the Visually Impaired (HEAVI), which quantifies the number of in-home fall-related hazards and found that neither the number of hazards nor the percentage of hazardous items were associated falls/year. However, each 10-fold increase in lighting was associated with a 35% lower rate of falls/year (RR=0.65, 95%CI=0.46 to 0.92) and there was a 50% reduction in falls/year when lighting was at or above 30 footcandles (minimum lighting level recommended by the Engineering Society of North America) compared to lighting <30 footcandles (RR=0.50, 95%CI=0.26 to 0.96).

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