Chung GC, Marottoli RA, Cooney LM, Rhee TG. Cost-Related Medication Nonadherence Among Older Adults: Findings From a Nationally Representative Sample.
J Am Geriatr Soc 2019;
67:2463-2473. [PMID:
31437309 DOI:
10.1111/jgs.16141]
[Citation(s) in RCA: 28] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2019] [Revised: 05/15/2019] [Accepted: 05/18/2019] [Indexed: 11/28/2022]
Abstract
OBJECTIVES
To estimate the rate of and risk factors associated with cost-related medication nonadherence among older adults.
DESIGN
Cross-sectional analysis of the 2017 National Health Interview Survey (NHIS).
SETTING
Nationally representative health interview survey in the United States.
PARTICIPANTS
Survey respondents, aged 65 years or older (n = 5701 unweighted) in the 2017 wave of the NHIS.
MEASUREMENTS
Self-reported, cost-related medication nonadherence (due to cost: skip dose, reduce dose, or delay or not fill a prescription) and actions taken due to cost-related medication nonadherence (ask for lower-cost prescription, use alternative therapy, or buy medications from another country) were quantified. We used a series of multivariable logistic regression analyses to identify factors associated with cost-related medication nonadherence. We also reported analyses by chronic disease subgroups.
RESULTS
In 2017, 408 (6.8%) of 5901 older adults, representative of 2.7 million older adults nationally, reported cost-related medication nonadherence. Among those with cost-related medication nonadherence, 44.2% asked a physician for lower-cost medications, 11.5% used alternative therapies, and 5.3% bought prescription drugs outside the United States to save money. Correlates independently associated with a higher likelihood of cost-related medication nonadherence included: younger age, female sex, lower socioeconomic levels (eg, low income and uninsured), mental distress, functional limitations, multimorbidities, and obesity (P < .05 for all). Similar patterns were found in subgroup analyses.
CONCLUSION
Cost-related medication nonadherence among older adults is increasingly common, with several potentially modifiable risk factors identified. Interventions, such as medication therapy management, may be needed to reduce cost-related medication nonadherence in older adults. J Am Geriatr Soc 67:2463-2473, 2019.
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