Cost-Related Medication Nonadherence in Adults With Diabetes in the United States: The National Health Interview Survey 2013–2018

<b>Objective:</b> Health-related expenditures due to diabetes are rising in the US. Medication nonadherence is associated with worse health outcomes among adults with diabetes. <a>We sought to examine the extent of reported cost-related medication nonadherence (CRN) in individuals with diabetes in the US</a>. <p><b>Research Design and Methods: </b>We studied adults ≥18 with self-reported diabetes from the National Health Interview Survey (NHIS; 2013-18), a US nationally representative survey. Adults reporting skipping doses, taking less medication, or delaying filling a prescription to save money in the past year were considered to have experienced CRN. The weighted prevalence of CRN was estimated overall and by age subgroups (<65 and ≥65 years). Logistic regression was used to identify sociodemographic characteristics independently associated with CRN. </p> <p><b>Results: </b>Of the 20,326 NHIS participants with diabetes, 17.6% (weighted: 2.3 million) of those aged <65 reported CRN, compared with 6.9% (weighted: 0.7 million) among those aged ≥65. Financial hardship from medical bills, lack of insurance, low-income, high comorbidity burden and female sex were independently associated with CRN across age groups. Lack of insurance, duration of diabetes, current smoking, hypertension, and hypercholesterolemia were associated with higher odds of reporting CRN among the non-elderly, but not among the elderly. Among elderly, insulin use significantly increased the odds of reporting CRN (OR 1.51, 95% CI 1.18, 1.92).</p> <p><b>Conclusions: </b>In the US, 1 in 6 non-elderly and 1 in 14 elderly adults with diabetes reported CRN. Removing financial barriers to accessing medications may improve medication adherence among these patients, with the potential to improve their outcomes.</p>

Cost-Related Medication Nonadherence in Adults With Diabetes in the United States: The National Health Interview Survey 2013–2018

<b>Objective:</b> Health-related expenditures due to diabetes are rising in the US. Medication nonadherence is associated with worse health outcomes among adults with diabetes. <a>We sought to examine the extent of reported cost-related medication nonadherence (CRN) in individuals with diabetes in the US</a>. <p><b>Research Design and Methods: </b>We studied adults ≥18 with self-reported diabetes from the National Health Interview Survey (NHIS; 2013-18), a US nationally representative survey. Adults reporting skipping doses, taking less medication, or delaying filling a prescription to save money in the past year were considered to have experienced CRN. The weighted prevalence of CRN was estimated overall and by age subgroups (<65 and ≥65 years). Logistic regression was used to identify sociodemographic characteristics independently associated with CRN. </p> <p><b>Results: </b>Of the 20,326 NHIS participants with diabetes, 17.6% (weighted: 2.3 million) of those aged <65 reported CRN, compared with 6.9% (weighted: 0.7 million) among those aged ≥65. Financial hardship from medical bills, lack of insurance, low-income, high comorbidity burden and female sex were independently associated with CRN across age groups. Lack of insurance, duration of diabetes, current smoking, hypertension, and hypercholesterolemia were associated with higher odds of reporting CRN among the non-elderly, but not among the elderly. Among elderly, insulin use significantly increased the odds of reporting CRN (OR 1.51, 95% CI 1.18, 1.92).</p> <p><b>Conclusions: </b>In the US, 1 in 6 non-elderly and 1 in 14 elderly adults with diabetes reported CRN. Removing financial barriers to accessing medications may improve medication adherence among these patients, with the potential to improve their outcomes.</p>

Use of Health Information Technology by Adults With Diabetes in the United States: Cross-sectional Analysis of National Health Interview Survey Data (2016-2018)

Background The use of health information technology (HIT) has been proposed to improve disease management in patients with type 2 diabetes mellitus. Objective This study aims to report the prevalence of HIT use in adults with diabetes in the United States and examine the factors associated with HIT use. Methods We analyzed data from 7999 adults who self-reported a diabetes diagnosis as collected by the National Health Interview Survey (2016-2018). All analyses were weighted to account for the complex survey design. Results Overall, 41.2% of adults with diabetes reported looking up health information on the web, and 22.8% used eHealth services (defined as filled a prescription on the web, scheduled an appointment with a health care provider on the web, or communicated with a health care provider via email). In multivariable models, patients who were female (vs male: prevalence ratio [PR] 1.16, 95% CI 1.10-1.24), had higher education (above college vs less than high school: PR 3.61, 95% CI 3.01-4.33), had higher income (high income vs poor: PR 1.40, 95% CI 1.23-1.59), or had obesity (vs normal weight: PR 1.11, 95% CI 1.01-1.22) were more likely to search for health information on the web. Similar associations were observed among age, race and ethnicity, education, income, and the use of eHealth services. Patients on insulin were more likely to use eHealth services (on insulin vs no medication: PR 1.21, 95% CI 1.04-1.41). Conclusions Among adults with diabetes, HIT use was lower in those who were older, were members of racial minority groups, had less formal education, or had lower household income. Health education interventions promoted through HIT should account for sociodemographic factors.

Cost-Related Medication Nonadherence in Adults With Diabetes in the United States: The National Health Interview Survey 2013–2018

OBJECTIVE Health-related expenditures resulting from diabetes are rising in the U.S. Medication nonadherence is associated with worse health outcomes among adults with diabetes. We sought to examine the extent of reported cost-related medication nonadherence (CRN) in individuals with diabetes in the U.S. RESEARCH DESIGN AND METHODS We studied adults age ≥18 years with self-reported diabetes from the National Health Interview Survey (NHIS) (2013–2018), a U.S. nationally representative survey. Adults reporting skipping doses, taking less medication, or delaying filling a prescription to save money in the past year were considered to have experienced CRN. The weighted prevalence of CRN was estimated overall and by age subgroups (&lt;65 and ≥65 years). Logistic regression was used to identify sociodemographic characteristics independently associated with CRN. RESULTS Of the 20,326 NHIS participants with diabetes, 17.6% (weighted 2.3 million) of those age &lt;65 years reported CRN, compared with 6.9% (weighted 0.7 million) among those age ≥65 years. Financial hardship from medical bills, lack of insurance, low income, high comorbidity burden, and female sex were independently associated with CRN across age groups. Lack of insurance, duration of diabetes, current smoking, hypertension, and hypercholesterolemia were associated with higher odds of reporting CRN among the nonelderly but not among the elderly. Among the elderly, insulin use significantly increased the odds of reporting CRN (odds ratio 1.51; 95% CI 1.18, 1.92). CONCLUSIONS In the U.S., one in six nonelderly and one in 14 elderly adults with diabetes reported CRN. Removing financial barriers to accessing medications may improve medication adherence among these patients, with the potential to improve their outcomes.

Correction to: Modeling mortality risk effects of cigarettes and smokeless tobacco: results from the national health interview survey linked mortality file data

An amendment to this paper has been published and can be accessed via the original article.