Cost-Related Medication Non-adherence, Cost Coping Behaviors, and Cost Conversations Among Individuals with and Without
- PDF / 158,463 Bytes
- 3 Pages / 595.276 x 790.866 pts Page_size
- 58 Downloads / 218 Views
J Gen Intern Med DOI: 10.1007/s11606-020-06176-4 © Society of General Internal Medicine 2020
for spending less on basic needs to pay for medication in a multivariable logistic regression model.
RESULTS INTRODUCTION
Patients with chronic conditions, particularly diabetes mellitus, are at high risk for cost-related medication nonadherence.1, 2 Cost coping behaviors, including cutting back on basic needs, skipping doses of medication, or asking for samples, have been documented among patients with chronic diseases.1, 3 Some of these behaviors, particularly cutting back on basic needs such as food, could be detrimental to diabetes management.4 Physicians may be aware that cost coping occurs; however, they may not have cost conversations with patients even when indicated.2, 5, 6 We compared cost coping behaviors and cost conversations among individuals with and without diabetes who have multiple chronic conditions.
METHODS
We consented 270 participants (81 with diabetes and 189 without diabetes) recruited through community primary care clinics, an academic multi-specialty clinic, and local newspaper ad in St. Louis, MO, for one survey, administered by a trained research assistant, between 12/21/2016 and 12/06/ 2017. Individuals were eligible if they were aged 35–80 years, English-speaking, with at least one chronic health condition, and taking at least one medication. The study was approved by the Washington University Human Research Protection office on 03/09/2016. Survey topics included demographics, healthcare utilization and literacy, medications and diagnoses, financial strain, and provider communication. We conducted bivariate comparisons of participants with and without selfreported diabetes using Student’s t test for continuous variables and chi-square or Fisher’s exact test for categorical variables. We examined diabetes as an independent risk factor Prior Presentations Preliminary findings from this study were reported at the 79th Scientific Sessions of the American Diabetes Association from June 7 to 11, 2019, in San Francisco, CA. Received May 15, 2020 Accepted August 20, 2020
There were no statistically significant differences between participants with and without diabetes on sex, race/ethnicity, or marital status, but those with diabetes were older than individuals without diabetes (58.4 v. 53.8 years, p < 0.001) (Table 1). Both groups were majority Black non-Hispanic (> 80%) and had multiple comorbidities. Compared with individuals without diabetes, a lower proportion of individuals with diabetes had monthly income < $800 (33.8% v. 51.3%, p = 0.008) and a higher proportion had private insurance or Medicare (40.7% v. 22.8%, p = 0.003). Individuals with diabetes had higher estimated medication costs and were more likely to use medical supplies and to have asked for and received medication samples. On financial strain measures, individuals with diabetes were more likely to report spending less on basic needs to pay for medications (58.0% v. 41.8%, p = 0.01) and have filed for bankruptcy (38.3% v. 21.7%
Data Loading...
