The Role of Gender in Cost-Related Medication Nonadherence Among Patients with Diabetes

Journal of the American Board of Family Medicine: JABFM

Oluwaseyi O. Isehunwa^1¹  Lu Ning^1²  Jay Bhatt^1³  Aastha Chandak^1⁴  Pallav Deka^1⁵  David Wyant^1⁶  Yang Wang^1⁷  Wang Jun Lin^1⁸  Sean Huang^1⁹  Olayinka Shiyanbola^1^1,10  Soumitra S. Bhuyan^1^1,11 

[1] Analytica Laser, New York, NY (AC);Department of Clinical Pharmacy, University of Tennessee Health Sciences Center, TN (WJL);Department of Health Administration, Governor State University, IL (LN);Department of Health Systems Administration, Georgetown University, Washington D.C. (SH);Department of Nursing, University of South Dakota, Sioux Falls, SD (PD);Fogelman College of Business and Economics, The University of Memphis, Memphis, TN (CFC)^1;Health Research and Educational Trust, Chicago, IL (JB);Jack C. Massey College of Business, Belmont University, TN (DW);Joseph J. Zilber School of Public Health, University of Wisconsin-Milwaukee, WI (YW);School of Pharmacy, University of Wisconsin, Madison, WI (OS);From School of Public Health, The University of Memphis, Memphis, TN (SSB, OOI, SK)

关键词: Blood Glucose;    Diabetes Mellitus;    Drug Costs;    Health Expenditures;    Medication Adherence;    Outcome Measure;   

DOI  :  10.3122/jabfm.2018.05.180039

学科分类：过敏症与临床免疫学

来源: The American Board of Family Medicine

【 摘 要 】

Objective: Under 50% of type 2 diabetic patients achieve the recommended glycemic control. One barrier to glycemic control is patients' cost-related nonadherence to medications. We hypothesize gender differences in medication nonadherence due to costs among diabetic patients. Methods: US National Health Interview Survey (2011 to 2014) data yielded 5260 males and 6188 females with diabetes for over a year. We applied 2 analytic methods (A and B below) across multiple outcome measures (1 to 4) of medication nonadherence due to cost. The key independent variable was participant's gender. Results: Across methods and measure, females consistently report significantly higher rates of medication nonadherence due to costs. Pearson's χ² showed that female patients were more likely to (1) skip medication (13.5%–10.2%; P < .001), take less than prescribed medication (13.9%–10.5%; P < .001), delay filling prescriptions (16.8%–12.5%; P < .001), and ask doctors to prescribe lower-cost alternative medications (31.8%–28.0%; P < .001). Controlling for covariates, logistic regression models found females more likely to skip medication (OR, 1.30; 95% CI, 1.09–1.55), take less than prescribed medication (OR, 1.26; 95%, CI, 1.06–1.50), delay filling prescriptions, (OR, 1.29; 95% CI, 1.11–1.50), and request lower-cost medication (OR, 1.17; 95% CI, 1.04–1.32). Our results report other factors that influence medication adherence, including socioeconomic and health status variables. Conclusions: A significant gender-based disparity exists on cost-related nonadherence of medication among diabetic patients. Health care providers and policy-makers should pay close attention to find ways to address cost-related nonadherence of medication among patients with chronic illness, especially among female patients.

【 授权许可】

CC BY