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- Title
Race/ethnicity and nonadherence to prescription medications among seniors: results of a national study.
- Authors
Gellad, Walid F.; Haas, Jennifer S.; Safran, Dana Gelb
- Abstract
<bold>Background: </bold>Nonadherence to prescription drugs results in poorer control of chronic health conditions. Because of significant racial/ethnic disparities in the control of many chronic diseases, differences in the rates of and reasons for medication nonadherence should be studied.<bold>Objectives: </bold>1) To determine whether rates of and reasons for medication nonadherence vary by race/ethnicity among seniors; and 2) to evaluate whether any association between race/ethnicity and nonadherence is moderated by prescription coverage and income.<bold>Design/setting: </bold>Cross-sectional national survey, 2003.<bold>Patients: </bold>Medicare beneficiaries > or = 65 years of age, who reported their race/ethnicity as white, black, or Hispanic, and who reported taking at least 1 medication (n = 14,829).<bold>Main Outcome Measures: </bold>Self-reported nonadherence (caused by cost, self-assessed need, or experiences/side effects) during the last 12 months.<bold>Results: </bold>Blacks and Hispanics were more likely than whites to report cost-related nonadherence (35.1%, 36.5%, and 26.7%, respectively, p < .001). There were no racial/ethnic differences in nonadherence caused by experiences or self-assessed need. In analyses controlling for age, gender, number of chronic conditions and medications, education, and presence and type of prescription drug coverage, blacks (odds ratio [OR] 1.38; 95% confidence interval [CI] 1.08-1.78) and Hispanics (1.35; 1.02-1.78) remained more likely to report cost-related nonadherence compared to whites. When income was added to the model, the relationship between cost-related nonadherence and race/ethnicity was no longer statistically significant (p = .12).<bold>Conclusions: </bold>Racial/ethnic disparities in medication nonadherence exist among seniors, and are related to cost concerns, and not to differences in experiences or self-assessed need. Considering the importance of medication adherence in controlling chronic diseases, affordability of prescriptions should be explicitly addressed to reduce racial/ethnic disparities.
- Subjects
UNITED States; MEDICAL care costs; DRUGS; MEDICARE beneficiaries; ETHNICITY; CHRONIC diseases; HEALTH policy; STATISTICS on Black people; STATISTICS on Hispanic Americans; DRUG therapy; COMPARATIVE studies; RESEARCH methodology; MEDICAL cooperation; MEDICARE; MULTIVARIATE analysis; PATIENT compliance; POVERTY; RESEARCH; SURVEYS; WHITE people; LOGISTIC regression analysis; EVALUATION research; CROSS-sectional method
- Publication
JGIM: Journal of General Internal Medicine, 2007, Vol 22, Issue 11, p1572
- ISSN
0884-8734
- Publication type
journal article
- DOI
10.1007/s11606-007-0385-z