Is patients' insurance coverage associated with prescribing after hospitalization for severe, poorly controlled hypertension?
Is patients' insurance coverage associated with prescribing after hospitalization for severe, poorly controlled hypertension?
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患者的保险范围是否与住院后因严重、控制不佳的高血压而开药有关？
DOI：
10.1111/j.1751-7176.2008.00004.x
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发表时间：
2008
期刊：
影响因子：
--
通讯作者：
Young,JHunter
中科院分区：
文献类型：
--
作者：
Dy,SydneyMorss;Klag,MichaelJ;Young,JHunter
高药物费用可能是不依从的一个重要原因，并威胁到高血压治疗的最新进展。目前还不清楚处方模式是否与患者的保险范围不同。本研究的目的是确定保险范围、报告的难以提供药物或不依从性是否与高风险人群中的抗高血压处方相关。作者对189名因严重、控制不佳的高血压而入住市中心学术医院的患者进行了横断面调查。患者的药物可及性差（三分之一缺乏保险，一半报告难以负担药物）与入院或出院方案费用无关。在每类药物中替换最便宜的药物将使成本降低42%，减少钙通道阻滞剂的使用将显著降低成本。总之，药物获取不良的标志与处方模式无关。需要进一步研究，以探讨这些模式及其对弱势群体的经济负担和遵守情况的影响。
High medication costs may be a significant cause of nonadherence and threaten recent gains in hypertension treatment. It is unclear whether prescribing patterns differ with patients’ insurance coverage. The objective of this study was to determine whether insurance coverage, reported difficulty affording medications, or nonadherence were associated with antihypertensive prescribing in a high‐risk population. The authors conducted a cross‐sectional survey of 189 patients admitted to an inner‐city academic hospital with severe, poorly controlled hypertension. Patients’ poor medication access (one‐third lacked insurance and half reported difficulty affording medications) was not associated with admission or discharge regimen costs. Substituting the least expensive drug within each class would have reduced costs by 42%, and reducing calcium channel blocker use would have significantly reduced costs. In conclusion, markers of poor medication access were not associated with prescribing patterns. Further research is needed to explore these patterns and their impact on vulnerable populations’ financial burden and adherence.