The Effects of Financial Pressures on Adherence and Glucose Control Among Racial/Ethnically Diverse Patients with Diabetes

Ngo‐Metzger, Quyen; Sorkin, Dara H.; Billimek, John; Greenfield, Sheldon; Kaplan, Sherrie H.

doi:10.1007/s11606-011-1910-7

Cited by 80 publications

(85 citation statements)

References 19 publications

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“…Eight of the 12 studies testing unadjusted disparities found NHBs[62–66; 68; 72] and, separately, Hispanics[62; 63; 65–67] were less adherent in taking medications than NHWs. Three of the six studies testing adjusted disparities found NHBs[62; 68; 70] and, separately, Hispanics[62; 70] were less adherent to medications than NHWs.…”

Section: Resultsmentioning

confidence: 99%

Self-Care Disparities Among Adults with Type 2 Diabetes in the USA

et al. 2016

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Suboptimal glycemic control is more common among Non-Hispanic Blacks (NHBs) and Hispanics than non-Hispanic Whites (NHWs). Disparities in the performance of self-care behaviors may contribute to this. To synthesize knowledge on current self-care disparities, we reviewed studies from January 2011-March 2016 that included NHWs, NHBs, and Hispanics with type 2 diabetes in the United States. Self-care behaviors included diet, exercise, medications, self-monitoring of blood glucose (SMBG), self-foot exams, and not smoking. Of 1,241 articles identified in PubMed, 25 met our inclusion criteria. These studies report consistent disparities in medication adherence. Surprisingly, we found consistent evidence of no disparities in exercise and some evidence of reverse disparities: compared to NHWs, Hispanics had healthier diets and NHBs had more regular SMBG. Consistent use of validated measures could further inform disparities in diet and exercise. Additional research is needed to test for disparities in self-foot exams, smoking, and diabetes-specific problem solving and coping.

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Section: Resultsmentioning

confidence: 99%

Self-Care Disparities Among Adults with Type 2 Diabetes in the USA

et al. 2016

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“…Previous studies have established an association between food insecurity 6–8 and cost-related medication underuse 11–13 with diabetes control when examining their specific unmet need of interest in isolation. This study builds on these by examining material need insecurity in a broader context of both competing material need insecurities and non-economic social circumstances, including health literacy and nativity.…”

Section: Discussionmentioning

confidence: 99%

Material Need Insecurities, Control of Diabetes Mellitus, and Use of Health Care Resources

et al. 2015

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“…Associations between perceived financial burden and poor glucose control among diabetes patients in outpatient clinics have been observed. 11 Rates of food insecurity are as high as 54% among older adults with diabetes 12 , and those pressures may lead to decreased adherence to diabetes self-care behaviors and worse glycemic control. 13,14,15 Dietary regimens are common therapeutic strategies integral to prevention and effective management of chronic disease, yet also vulnerable to CRN.…”

Section: Introductionmentioning

confidence: 99%

Social Determinants of Health, Cost-related Nonadherence, and Cost-reducing Behaviors Among Adults With Diabetes

et al. 2016

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Background Cost-related non-adherence (CRN) is prevalent among individuals with diabetes and can have significant negative health consequences. We examined health and non-health-related pressures and the use of cost-reducing strategies among the U.S. adult population with and without diabetes that may impact CRN. Methods Data from the 2013 wave of National Health Interview Survey (n=34,557) were used to identify the independent impact of perceived financial stress, financial insecurity with healthcare, food insecurity, and cost-reducing strategies on CRN. Results 11% (n=4,158) of adults reported diabetes. 14% with diabetes reported CRN, compared to 7% without. Greater perceived financial stress (Prevalence Ratio (PR)=1.07 [95% CI: 1.05 to 1.09]), financial insecurity with healthcare (PR=1.6 [95% CI: 1.5 to 1.67]), and food insecurity (PR=1.30 [95% CI: 1.2 to 1.4]) were all associated with a greater likelihood of CRN. Asking the doctor for a lower cost medication was associated with a lower likelihood of CRN (PR=0.2 [95% CI: 0.2 to 0.3]), and 27% with CRN reported this. Other cost-reducing behavioral strategies (using alternative therapies, buying prescriptions overseas) were associated with a greater likelihood of CRN. Conclusions Half of adults with diabetes perceived financial stress, and one-fifth reported financial insecurity with healthcare and food insecurity. Talking to a health care provider about low-cost options may be protective against CRN in some situations. Improving screening and communication to identify CRN and increase transparency of low-cost options patients are pursuing may help safeguard from the health consequences of cutting back on treatment.

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The Effects of Financial Pressures on Adherence and Glucose Control Among Racial/Ethnically Diverse Patients with Diabetes

Cited by 80 publications

References 19 publications

Self-Care Disparities Among Adults with Type 2 Diabetes in the USA

Self-Care Disparities Among Adults with Type 2 Diabetes in the USA

Material Need Insecurities, Control of Diabetes Mellitus, and Use of Health Care Resources

Social Determinants of Health, Cost-related Nonadherence, and Cost-reducing Behaviors Among Adults With Diabetes

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