Medication cost-reducing behaviors in older adults with atrial fibrillation: The SAGE-AF study.
Medication cost-reducing behaviors in older adults with atrial fibrillation: The SAGE-AF study.
复制标题
DOI：
10.1016/j.japh.2022.08.030
复制
发表时间：
2023-01
影响因子：
2.1
通讯作者：
Saczynski, Jane S.
中科院分区：
文献类型：
--
作者：
Bamgbade, Benita A.;McManus, David D.;Briesacher, Becky A.;Lessard, Darleen;Mehawej, Jordy;Gurwitz, Jerry H.;Tisminetzky, Mayra;Mujumdar, Sarika;Wang, Weija;Malihot, Tanya;Abu, Hawa O.;Waring, Molly;Sogade, Felix;Madden, Jeanne;-Louis, Isabelle C. Pierre;Helm, Robert;Goldberg, Robert;Kramer, Arthur F.;Saczynski, Jane S.
由于美国许多药物的患者价格急剧上涨，患者可能会采取降低成本的行为（crb），例如要求使用仿制药或从互联网上购买药物。本研究的目的是描述老年房颤（AF）患者的CRB模式，与费用相关的药物不依从性，以及在基本需求上花费较少的药物，并检查与CRB相关的参与者特征。数据来自一项前瞻性队列研究，研究对象为至少65岁的房颤和高卒中风险（CHA2DS2VASc≥2）的老年人。CRB，与费用相关的药物不依从性，以及在基本需求上花费较少的药物使用经过验证的措施进行评估。采用卡方检验和t检验评价各CRB的特征差异，并将有统计学意义的特征（P < 0.05）纳入多变量logistic回归检验与CRB相关的因素。在参与者（N = 1224；平均年龄76岁；49%为女性）中，69%报告参与CRB， 4%报告与费用相关的药物不依从，6%报告在基本需求上的支出减少。认知障碍（校正优势比0.69 [95% CI 0.52-0.91]）和非西班牙裔白人（0.66[0.46-0.95]）的参与者参与CRB的可能性较小。已婚（1.88[1.30-2.72]）、家庭收入在20,000- 49,999美元（1.52[1.02-2.27]）、有医疗保险（1.38[1.04-1.83]）、有4-6个合并症（1.43[1.01-2.01]）的参与者参与CRB的几率显著更高。尽管crb在老年房颤患者中很常见，但很少有人报告与费用相关的药物不依从和基本需求支出减少。认知障碍患者可能受益于药剂师干预，在CRB和患者援助计划中提供支持。
As patient prices for many medications have risen steeply in the United States, patients may engage in cost-reducing behaviors (CRBs) such as asking for generic medications or purchasing medication from the Internet. The objective of this study is to describe patterns of CRB, cost-related medication nonadherence, and spending less on basic needs to afford medications among older adults with atrial fibrillation (AF) and examine participant characteristics associated with CRB. Data were from a prospective cohort study of older adults at least 65 years with AF and a high stroke risk (CHA2DS2VASc ≥ 2). CRB, cost-related medication nonadherence, and spending less on basic needs to afford medications were evaluated using validated measures. Chi-square and t tests were used to evaluate differences in characteristics across CRB, and statistically significant characteristics (P < 0.05) were entered into a multivariable logistic regression to examine factors associated with CRB. Among participants (N = 1224; mean age 76 years; 49% female), 69% reported engaging in CRB, 4% reported cost-related medication nonadherence, and 6% reported spending less on basic needs. Participants who were cognitively impaired (adjusted odds ratio 0.69 [95% CI 0.52–0.91]) and those who did not identify as non-Hispanic white (0.66 [0.46–0.95]) were less likely to engage in CRB. Participants who were married (1.88 [1.30–2.72]), had a household income of $20,000-$49,999 (1.52 [1.02–2.27]), had Medicare insurance (1.38 [1.04–1.83]), and had 4–6 comorbidities (1.43 [1.01–2.01]) had significantly higher odds of engaging in CRB. Although CRBs were common among older adults with AF, few reported cost-related medication nonadherence and spending less on basic needs. Patients with cognitive impairment may benefit from pharmacist intervention to provide support in CRB and patient assistance programs.
登录
查看更多内容
影响因子：
2.8
作者：
Hawkins, Lee Ann;Kilian, Shirley;Silvet, Helme
通讯作者：
Silvet, Helme
影响因子：
3
作者：
Burcu, Mehmet;Alexander, G. Caleb;Harrington, Donna
通讯作者：
Harrington, Donna
影响因子：
5.4
作者：
Chen, Nemin;Alam, Aniqa B.;Alonso, Alvaro
通讯作者：
Alonso, Alvaro
影响因子：
6.3
作者：
Saczynski, Jane S.;Sanghai, Saket R.;McManus, David D.
通讯作者：
McManus, David D.
影响因子：
3
作者：
Nekui F;Galbraith AA;Briesacher BA;Zhang F;Soumerai SB;Ross-Degnan D;Gurwitz JH;Madden JM
通讯作者：
Madden JM