Cost-Related Medication Nonadherence in Adults With Diabetes in the United States: The National Health Interview Survey 2013-2018
Cost-Related Medication Nonadherence in Adults With Diabetes in the United States: The National Health Interview Survey 2013-2018
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DOI：
10.2337/dc21-1757
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发表时间：
2022-03-01
期刊：
影响因子：
16.2
通讯作者：
Nasir, Khurram
中科院分区：
文献类型：
--
作者：
Taha, Mohamad B.;Valero-Elizondo, Javier;Nasir, Khurram
在美国，糖尿病引起的健康相关支出正在上升。药物治疗不依从性与糖尿病成人的健康状况恶化有关。我们试图检查美国糖尿病患者中报告的成本相关药物不依从性（CRN）的程度研究设计和方法我们研究了美国国家健康访谈调查（NHIS）（2013-2018）中年龄≥ 18岁的自我报告糖尿病的成年人，这是一项美国全国代表性调查。在过去的一年里，报告跳过剂量，服用较少药物或延迟填写处方以节省资金的成年人被认为经历了CRN。CRN的加权患病率估计总体和年龄亚组（= 65岁）。Logistic回归分析用于确定与CRN独立相关的社会人口学特征。在20，326名NHIS糖尿病患者中，17.6%（加权230万）年龄≥ 65岁。来自医疗账单的经济困难，缺乏保险，低收入，高comorbenefit负担和女性性别与各年龄组的CRN独立相关。在非老年人中，缺乏保险、糖尿病病程、目前吸烟、高血压和高胆固醇血症与CRN的发生率较高相关，而在老年人中则无关。在老年人中，胰岛素使用显著增加了报告CRN的几率（比值比1.51; 95%CI 1.18，1.92）。1/6的非老年糖尿病患者和1/14的老年糖尿病患者报告CRN。消除获得药物的经济障碍可能会改善这些患者的药物依从性，并有可能改善他们的结果。
OBJECTIVEHealth-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 METHODSWe 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 years). Logistic regression was used to identify sociodemographic characteristics independently associated with CRN.RESULTSOf the 20,326 NHIS participants with diabetes, 17.6% (weighted 2.3 million) of 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).CONCLUSIONSIn 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.