Noncompliance in the Use of Cardiovascular Medications in the Medicare Part D Population

Blackwell, Steven A.; Baugh, David K.; Montgomery, Melissa A.; Ciborowski, Gary M.; Waldron, Charles J.; Riley, Gerald F.

doi:10.5600/mmrr.001.04.a05

Cited by 8 publications

(8 citation statements)

References 35 publications

(36 reference statements)

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“…We report two primary findings. First, consistent with existing literature, we found that nonwhite patients were more likely to be nonadherent than white patients 45,46. Second, we determined that factors associated with nonadherence did not differ as a function of patients’ race.…”

Section: Discussionsupporting

confidence: 83%

Patient–provider communication, self-reported medication adherence, and race in a postmyocardial infarction population

Zullig¹,

Shaw²,

Shah³

et al. 2015

PPA

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ObjectivesOur objectives were to: 1) describe patient-reported communication with their provider and explore differences in perceptions of racially diverse adherent versus nonadherent patients; and 2) examine whether the association between unanswered questions and patient-reported medication nonadherence varied as a function of patients’ race.MethodsWe conducted a cross-sectional analysis of baseline in-person survey data from a trial designed to improve postmyocardial infarction management of cardiovascular disease risk factors.ResultsOverall, 298 patients (74%) reported never leaving their doctor’s office with unanswered questions. Among those who were adherent and nonadherent with their medications, 183 (79%) and 115 (67%) patients, respectively, never left their doctor’s office with unanswered questions. In multivariable logistic regression, although the simple effects of the interaction term were different for patients of nonminority race (odds ratio [OR]: 2.16; 95% confidence interval [CI]: 1.19–3.92) and those of minority race (OR: 1.19; 95% CI: 0.54–2.66), the overall interaction effect was not statistically significant (P=0.24).ConclusionThe quality of patient–provider communication is critical for cardiovascular disease medication adherence. In this study, however, having unanswered questions did not impact medication adherence differently as a function of patients’ race. Nevertheless, there were racial differences in medication adherence that may need to be addressed to ensure optimal adherence and health outcomes. Effort should be made to provide training opportunities for both patients and their providers to ensure strong communication skills and to address potential differences in medication adherence in patients of diverse backgrounds.

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Section: Discussionsupporting

confidence: 83%

Patient–provider communication, self-reported medication adherence, and race in a postmyocardial infarction population

Zullig¹,

Shaw²,

Shah³

et al. 2015

PPA

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“…The implementation of the Medicare Part D program has been associated with up to a 13.5% improvement in antihypertensive adherence among beneficiaries (8). However, antihypertensive nonadherence continues to pose a threat to this population's health, especially among certain demographic groups (9). This study used the most currently available data to describe antihypertensive nonadherence among Medicare Part D beneficiaries, and assessed nonadherence stratified by multiple factors, including antihypertensive class and beneficiaries' state and county of residence, type of prescription drug plan, and treatment and demographic characteristics, to help identify and inform targeted interventions among the groups and regions most at risk.…”

Section: Introductionmentioning

confidence: 99%

Vital Signs: Disparities in Antihypertensive Medication Nonadherence Among Medicare Part D Beneficiaries — United States, 2014

Ritchey¹,

Chang²,

Powers³

et al. 2016

MMWR Morb. Mortal. Wkly. Rep.

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Introduction: Nonadherence to taking prescribed antihypertensive medication (antihypertensive) regimens has been identified as a leading cause of poor blood pressure control among persons with hypertension and an important risk factor for adverse cardiovascular disease outcomes. CDC and the Centers for Medicare and Medicaid Services analyzed geographic, racial-ethnic, and other disparities in nonadherence to antihypertensives among Medicare Part D beneficiaries in 2014. Methods: Antihypertensive nonadherence, defined as a proportion of days a beneficiary was covered with antihypertensives of <80%, was assessed using prescription drug claims data among Medicare Advantage or Medicare fee-for-service beneficiaries aged ≥65 years with Medicare Part D coverage during 2014 (N = 18.5 million). Analyses were stratified by antihypertensive class, beneficiaries' state and county of residence, type of prescription drug plan, and treatment and demographic characteristics. Conclusions and Implications for Public Health Practice: More than one in four Medicare Part D beneficiaries using antihypertensives were nonadherent to their regimen, and certain racial/ethnic groups, states, and geographic areas were at increased risk for nonadherence. These findings can help inform focused interventions among these groups, which might improve blood pressure control and cardiovascular disease outcomes.

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“…OTC medicine is usually considered safe to use and available for self-medication [ 1 , 3 ]. Even though OTC medicines are comparably safe and mild in effects, the misuse of medicine, which was proven not rare in the UK, can still lead to severe consequences such as addiction and fatality [ 4 , 5 , 6 ]. This situation has raised concern since medicines such as OTC codeine, the most widely used opioid medicine, is very likely to cause harm [ 7 , 8 , 9 ].…”

Section: Introductionmentioning

confidence: 99%

Designing Effective Warnings about Addiction on the Patient Information Leaflet of Over-the-Counter Codeine Sold in England to University Students

Zhao

Chen

Han

et al. 2020

IJERPH

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(1) Background: The harm of misusing over-the-counter (OTC) codeine-containing medicines among university students in England is being increasingly recognized. Based on English university students, this paper aims to study the importance of information design on information communication, explore methods for effective warning design, and investigate university students’ perception of OTC codeine. (2) Methods: The effective warning design is addressed through case studies, answering correctness by the heat map generated from the eye-tracking experiment (ETE), and the total time spent on the tasks. User perceptions are made though online surveys. (3) Results: Information design significantly affects the way user processes information. Therefore, two emphasized warnings displayed in the headline, and the “possible side effect (PSE)” sections and warning signs of addiction presented under the PSE are suggested as effective ways to display warnings. For students’ perception of OTC codeine, 80% of university students are unfamiliar with the substance. After reading the patient information leaflets (PILs), 47% recommended tight regulation on codeine. (4) Conclusions: The misuse of OTC codeine could be a potential problem among English university students. The design of the PIL significantly influences the chance of unintentional medicine misuse. The display of warnings on the PILs of OTC codeine should be redesigned for better understanding.

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Noncompliance in the Use of Cardiovascular Medications in the Medicare Part D Population

Cited by 8 publications

References 35 publications

Patient–provider communication, self-reported medication adherence, and race in a postmyocardial infarction population

Patient–provider communication, self-reported medication adherence, and race in a postmyocardial infarction population

Vital Signs: Disparities in Antihypertensive Medication Nonadherence Among Medicare Part D Beneficiaries — United States, 2014

Designing Effective Warnings about Addiction on the Patient Information Leaflet of Over-the-Counter Codeine Sold in England to University Students

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Noncompliance in the Use of Cardiovascular Medications in the Medicare Part D Population

Cited by 8 publications

References 35 publications

Patient&ndash;provider communication, self-reported medication adherence, and race in a postmyocardial infarction population

Patient&ndash;provider communication, self-reported medication adherence, and race in a postmyocardial infarction population

Vital Signs: Disparities in Antihypertensive Medication Nonadherence Among Medicare Part D Beneficiaries — United States, 2014

Designing Effective Warnings about Addiction on the Patient Information Leaflet of Over-the-Counter Codeine Sold in England to University Students

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Product

Resources

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Patient–provider communication, self-reported medication adherence, and race in a postmyocardial infarction population

Patient–provider communication, self-reported medication adherence, and race in a postmyocardial infarction population