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>

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.

Medication Nonadherence: Implications for patient health outcomes in pharmacy practice

ABSTRACT Objectives: The primary objective of this review is (1) to better understand the prevalence and impact of medication nonadherence, (2) to identify risk factors for medication nonadherence, (3) to understand the association between nonadherence and its implications on patient health outcomes in pharmacy practice, and (4) to study interventions designed to improve patient adherence to prescribed medications for medical conditions, considering its impact on both medication adherence and patient health outcomes. Methods: Published journal articles were manually sorted. Additional references were obtained from citations within the retrieved articles. This review surveyed the findings of the identified articles with data extracted to presents various strategies and resources on medication nonadherence related to patients and healthcare providers. English languages were considered inclusion criteria in reviewing published articles related to medication nonadherence. This review also surveyed identified articles to determine both subjective and objective medication adherence measures. Key findings: The research in this field needs advances, including improved design of feasible long‐term interventions, objective adherence measures, and sufficient study power to detect improvements in patient health outcomes. Conclusion: Current methods of improving medication adherence for chronic health problems are mostly complex and ineffective so full benefits of treatment cannot be realized. To date, monitoring of patient medication adherence and use of interventions to improve adherence are rare in routine clinical practice.