TY - JOUR
T1 - Cost-Related Medication Nonadherence in Adults With Diabetes in the United States
T2 - The National Health Interview Survey 2013–2018
AU - Taha, Mohamad B.
AU - Valero-Elizondo, Javier
AU - Yahya, Tamer
AU - Caraballo, César
AU - Khera, Rohan
AU - Patel, Kershaw V.
AU - Ali, Hyeon Ju R.
AU - Sharma, Garima
AU - Mossialos, Elias
AU - Cainzos-Achirica, Miguel
AU - Nasir, Khurram
N1 - Funding Information:
Funding. K.N. is supported in part by the Jer-old B. Katz Academy of Translational Research. Duality of Interest. K.N. is on the advisory boards of Amgen, Novartis, and Medicine Company. No other potential conflicts of interest relevant to this article were reported. Author Contributions. M.B.T., J.V.-E., T.Y., M.C.-A., and K.N. designed the study. M.B.T., J.V.-E., T.Y., and C.C. wrote the manuscript. J.V.-E. prepared the statistical analysis. M.B.T. prepared the figures. R.K., K.V.P., H.J.R.A., G.S., E.M., M.C.-A., and K.N. reviewed and edited the manuscript. All authors reviewed and revised the manuscript and agreed to the submission of the final manuscript J.V.-E. and K.N. are the guarantors of this work and, as such, had full access to all the data in the study and take responsibility for the integrity of the data and the accuracy of the data analysis.
Publisher Copyright:
© 2022 by the American Diabetes Association.
PY - 2022/3/1
Y1 - 2022/3/1
N2 - OBJECTIVE: Health-related expenditures resulting from diabetes are rising in the U.S. Medication nonadherence is associated with worse health outcomes among adults with diabetes. We sought to examine the extent of reported cost-related medication nonadherence (CRN) in individuals with diabetes in the U.S.RESEARCH DESIGN AND METHODS: We studied adults age ≥18 years with self-reported diabetes from the National Health Interview Survey (NHIS) (2013-2018), a U.S. nationally representative survey. Adults reporting skipping doses, taking less medication, or delaying filling a prescription to save money in the past year were considered to have experienced CRN. The weighted prevalence of CRN was estimated overall and by age subgroups (<65 and ≥65 years). Logistic regression was used to identify sociodemographic characteristics independently associated with CRN.RESULTS: Of the 20,326 NHIS participants with diabetes, 17.6% (weighted 2.3 million) of those age <65 years reported CRN, compared with 6.9% (weighted 0.7 million) among those age ≥65 years. Financial hardship from medical bills, lack of insurance, low income, high comorbidity burden, and female sex were independently associated with CRN across age groups. Lack of insurance, duration of diabetes, current smoking, hypertension, and hypercholesterolemia were associated with higher odds of reporting CRN among the nonelderly but not among the elderly. Among the elderly, insulin use significantly increased the odds of reporting CRN (odds ratio 1.51; 95% CI 1.18, 1.92).CONCLUSIONS: In the U.S., one in six nonelderly and one in 14 elderly adults with diabetes reported CRN. Removing financial barriers to accessing medications may improve medication adherence among these patients, with the potential to improve their outcomes.
AB - OBJECTIVE: Health-related expenditures resulting from diabetes are rising in the U.S. Medication nonadherence is associated with worse health outcomes among adults with diabetes. We sought to examine the extent of reported cost-related medication nonadherence (CRN) in individuals with diabetes in the U.S.RESEARCH DESIGN AND METHODS: We studied adults age ≥18 years with self-reported diabetes from the National Health Interview Survey (NHIS) (2013-2018), a U.S. nationally representative survey. Adults reporting skipping doses, taking less medication, or delaying filling a prescription to save money in the past year were considered to have experienced CRN. The weighted prevalence of CRN was estimated overall and by age subgroups (<65 and ≥65 years). Logistic regression was used to identify sociodemographic characteristics independently associated with CRN.RESULTS: Of the 20,326 NHIS participants with diabetes, 17.6% (weighted 2.3 million) of those age <65 years reported CRN, compared with 6.9% (weighted 0.7 million) among those age ≥65 years. Financial hardship from medical bills, lack of insurance, low income, high comorbidity burden, and female sex were independently associated with CRN across age groups. Lack of insurance, duration of diabetes, current smoking, hypertension, and hypercholesterolemia were associated with higher odds of reporting CRN among the nonelderly but not among the elderly. Among the elderly, insulin use significantly increased the odds of reporting CRN (odds ratio 1.51; 95% CI 1.18, 1.92).CONCLUSIONS: In the U.S., one in six nonelderly and one in 14 elderly adults with diabetes reported CRN. Removing financial barriers to accessing medications may improve medication adherence among these patients, with the potential to improve their outcomes.
KW - Adolescent
KW - Adult
KW - Aged
KW - Comorbidity
KW - Diabetes Mellitus/drug therapy
KW - Female
KW - Health Expenditures
KW - Humans
KW - Medication Adherence
KW - Surveys and Questionnaires
KW - United States
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U2 - 10.2337/dc21-1757
DO - 10.2337/dc21-1757
M3 - Article
C2 - 35015860
AN - SCOPUS:85125883753
SN - 0149-5992
VL - 45
SP - 594
EP - 603
JO - Diabetes care
JF - Diabetes care
IS - 3
ER -