A B S T R A C T PurposeNoncompliance with adjuvant hormonal therapy among women with breast cancer is common. Little is known about the impact of financial factors, such as co-payments, on noncompliance. Patients and MethodsWe conducted a retrospective cohort study by using the pharmacy and medical claims database at Medco Health Solutions. Women older than age 50 years who were taking aromatase inhibitors (AIs) for resected breast cancer with two or more mail-order prescriptions, from January 1, 2007, to December 31, 2008, were identified. Patients who were eligible for Medicare were analyzed separately. Nonpersistence was defined as a prescription supply gap of more than 45 days without subsequent refill. Nonadherence was defined as a medication possession ratio less than 80% of eligible days. ResultsOf 8,110 women younger than age 65 years, 1,721 (21.1%) were nonpersistent and 863 (10.6%) were nonadherent. Among 14,050 women age 65 years or older, 3,476 (24.7%) were nonpersistent and 1,248 (8.9%) were nonadherent. In a multivariate analysis, nonpersistence (ever/never) in both age groups was associated with older age, having a non-oncologist write the prescription, and having a higher number of other prescriptions. Compared with a co-payment of less than $30, a co-payment of $30 to $89.99 for a 90-day prescription was associated with less persistence in women age 65 years or older (odds ratio [OR], 0.69; 95% CI, 0.62 to 0.75) but not among women younger than age 65, although a co-payment of more than $90 was associated with less persistence both in women younger than age 65 (OR, 0.82; 95% CI, 0.72 to 0.94) and those age 65 years or older (OR, 0.72; 95% CI, 0.65 to 0.80). Similar results were seen with nonadherence. ConclusionWe found that higher prescription co-payments were associated with both nonpersistence and nonadherence to AIs. This relationship was stronger in older women. Because noncompliance is associated with worse outcomes, future policy efforts should be directed toward interventions that would help patients with financial difficulties obtain life-saving medications.
Background Accurate information and guidance about personal behaviors that can reduce exposure to severe acute respiratory syndrome coronavirus 2 are among the most important elements in mitigating the spread of coronavirus disease 2019 (COVID-19). With over 2 billion users, YouTube is a media channel that millions turn to when seeking information. Objective At the time of this study, there were no published studies investigating the content of YouTube videos related to COVID-19. This study aims to address this gap in the current knowledge. Methods The 100 most widely viewed YouTube videos uploaded throughout the month of January 2020 were reviewed and the content covered was described. Collectively, these videos were viewed over 125 million times. Results Fewer than one-third of the videos covered any of the seven key prevention behaviors listed on the US Centers for Disease Control and Prevention website. Conclusions These results represent an important missed opportunity for disease prevention.
ObjectivesTikTok is a popular social media platform, especially among those who are 13–24 years of age. The purpose of this cross-sectional study was to describe the content of COVID-19 material on TikTok.MethodsA total of 100 videos posted under the hashtag #Coronavirus were included in this study along with all (n=17) posts uploaded by the World Health Organization (WHO).ResultsOverall, these videos were viewed 1,194,081,700 times. The most commonly cited topics included anxiety (14.5%) with more than 190.6 million views and quarantine (10.3%) with 106.6 million views. Fewer than 10% of videos mentioned how the virus is transmitted, symptoms, and prevention. WHO videos more often focused on viral transmission and symptoms but covered these topics in fewer than 10% of the videos.ConclusionsAlthough research suggests that cases of COVID-19 may be less severe in those under 18 years of age, social distancing remains paramount due to the possibility of transmission even in those with minimal or no symptoms. For young adults in particular, the WHO suggests staying connected through social media and making every attempt to stay positive. TikTok has the potential, not only to convey important health information, but to address these aspects of the COVID-19 pandemic as well.
Objective: The purpose of this study was to assess the readability of information on the Internet posted about coronavirus disease 2019 (COVID-19) to determine how closely these materials are written to the recommended reading levels. Methods: Using the search term "coronavirus," information posted on the first 100 English language websites was identified. Using an online readability calculator, multiple readability tests were conducted to ensure a comprehensive representation would result. Results: The mean readability scores ranged between grade levels 6.2 and 17.8 (graduate school level).Four of the 5 measures (GFI, CLI, SMOG, FRE) found that readability exceeded the 10th grade reading level indicating that the text of these websites would be difficult for the average American to read. The mean reading level for nearly all noncommercial and commercial websites was at or above the 10th grade reading level. Conclusions: Messages about COVID-19 must be readable at an "easy" level, and must contain clear guidelines for behavior. The degree to which individuals seek information in response to risk messages is positively related to the expectation that the information will resolve uncertainty. However, if the information is too complex to interpret and it fails to lead to disambiguation, this can contribute to feelings of panic.
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