Race/Ethnicity and Nonadherence to Prescription Medications Among Seniors: Results of a National Study

Gellad, Walid F.; Haas, Jennifer S.; Safran, Dana Gelb

doi:10.1007/s11606-007-0385-z

Cited by 151 publications

(138 citation statements)

References 31 publications

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“…Race-related differences in cost-related underuse have been observed in outpatient studies, [6][7][8]12 and may be an important contributor to racial disparities in evidence-based medication use. [13][14][15] These differences may, in part, reflect racial variations in socioeconomic status; lower income patients, who are more likely to be from a racial or ethnic minority, are more sensitive to cost sharing than higher income individuals.…”

Section: Discussionmentioning

confidence: 92%

Cost‐related medication underuse: Prevalence among hospitalized managed care patients

Choudhry

Saya

Shrank

et al. 2011

Journal of Hospital Medicine

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BACKGROUND:The affordability of prescription medications continues to be a major public health issue in the United States. Estimates of cost‐related medication underuse come largely from surveys of ambulatory patients. Hospitalized patients may be vulnerable to cost‐related underuse and its consequences, but have been subject to little investigation.OBJECTIVE:To determine impact of medication costs in a cohort of hospitalized managed care beneficiaries.METHODS:We surveyed consecutive patients admitted to medical services at an academic medical center. Questions about cost‐related underuse were based on validated measures; predictors were assessed with multivariable models. Participants were asked about strategies to improve medication affordability, and were contacted after discharge to determine if they had filled newly prescribed medications.RESULTS:One‐hundred thirty (41%) of 316 potentially eligible patients participated; 93 (75%) of these completed postdischarge surveys. Thirty patients (23%) reported cost‐related underuse in the year prior to admission. In adjusted analyses, patients of black race were 3.39 times (95% confidence interval [CI], 1.05 to 11.02) more likely to report cost‐related underuse than non‐Hispanic white patients. Virtually all respondents (n = 123; 95%) endorsed at least 1 strategy to make medications more affordable. Few (16%) patients, prescribed medications at discharge, knew how much they would pay at the pharmacy. Almost none had spoken to their inpatient (4%) or outpatient (2%) providers about the cost of newly prescribed drugs.CONCLUSIONS:Cost‐related underuse is common among hospitalized patients. Individuals of black race appear to be particularly at risk. Strategies should be developed to address this issue around the time of hospital discharge. Journal of Hospital Medicine 2012. © 2011 Society of Hospital Medicine

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Section: Discussionmentioning

confidence: 92%

Cost‐related medication underuse: Prevalence among hospitalized managed care patients

Choudhry

Saya

Shrank

et al. 2011

Journal of Hospital Medicine

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“…23,24 Our findings are consistent with previous research in older US adults with chronic health conditions showing greater odds of cost-related nonadherence to medication among blacks and Hispanics compared with whites even after adjusting for demographic factors, comorbidity, or prescription drug coverage. 25 In previous studies of US stroke survivors, we obtained conflicting results for the association of being black with inability to afford medications. The study of age-related differences in medication access found an absence of association possibly due to insufficient power and confounding by Hispanic ethnicity.…”

Section: Discussionmentioning

confidence: 93%

Racial/ethnic disparities in access to physician care and medications among US stroke survivors

et al. 2011

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“…Given the findings that socioeconomic and health insurance status and barriers to quality care were related to adherence, these should be included as potential cofactors in future analyses of adherence. Particular attention should be paid to including these when comparing ethnic groups, because ethnic differences in adherence have been found to disappear when, for example, income was accounted for (73). As previously noted (56, 65), preferred language may be a better predictor of health patterns than ethnicity.…”

Section: Discussionmentioning

confidence: 99%

Psychotropic Medication Nonadherence Among United States Latinos: A Comprehensive Literature Review

Lanouette¹,

Folsom²,

Sciolla³

et al. 2009

Psychiatric Services

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Objective Psychotropic medication nonadherence is a major public health problem, but few studies have focused on Latinos. We systematically reviewed the literature on rates of and factors influencing antipsychotic, antidepressant, or mood stabilizer nonadherence among United States (US) Latinos. Methods Data Sources: MEDLINE and PsycINFO were searched using keywords adherence, compliance, Latino, Hispanic, psychotropic, and related terms, as well as bibliographies from relevant reviews and studies. Study Selection: 21 studies met inclusion criteria: published since 1980 in English or Spanish; measured psychotropic medication nonadherence rates among US Latino adults. Data Abstraction: We examined articles for study design and objective, location, population, medication type, participant demographics, adherence measure, adherence rates, and factors related to adherence. Results and Conclusions In studies including Latinos and other ethnic groups, mean nonadherence rates were 41%, 31%, and 43% among Latinos, Euro-Americans, and African Americans respectively, with an overall effect size of 0.64 between Latinos and Euro-Americans. In studies including only Latinos, the mean nonadherence rate was 44%. Ten of 16 studies found Latinos had significantly lower adherence rates than Euro-Americans. Risk factors for nonadherence included being monolingual Spanish speaking, lacking health insurance, experiencing barriers to quality care, and having lower socioeconomic status. Protective factors included family support and psychotherapy. Rates of nonadherence to psychotropic medications were higher for Latinos than for Euro-Americans. Further investigation is needed into the potentially modifiable individual and societal level mechanisms of this discrepancy. Clinical and research interventions to improve adherence should be culturally appropriate and incorporate identified factors.

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Race/Ethnicity and Nonadherence to Prescription Medications Among Seniors: Results of a National Study

Cited by 151 publications

References 31 publications

Cost‐related medication underuse: Prevalence among hospitalized managed care patients

Cost‐related medication underuse: Prevalence among hospitalized managed care patients

Racial/ethnic disparities in access to physician care and medications among US stroke survivors

Psychotropic Medication Nonadherence Among United States Latinos: A Comprehensive Literature Review

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