Impact of financial burden, resulting from prescription co-payments, on antihypertensive medication adherence in an older publically insured population.
Impact of financial burden, resulting from prescription co-payments, on antihypertensive medication adherence in an older publically insured population.
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DOI：
10.1186/s12889-018-6209-8
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发表时间：
2018-11-20
影响因子：
4.5
通讯作者：
Cousins G
中科院分区：
文献类型：
--
作者：
Dillon P;Smith SM;Gallagher P;Cousins G
药物共付额是抗高血压药物依从性的经济障碍。爱尔兰公共保险患者引入自付费用导致依从性下降 5%。然而，该人群存在社会经济差异，对低收入群体的影响可能更大。我们评估了一组爱尔兰公共保险抗高血压使用者的自付额与药物相关的财务负担，并测试了其与 12 个月依从性的关系。这是一项针对来自 106 个爱尔兰社区药房的社区居住老年人（>65 岁）（n=1152）的前瞻性队列研究。参与者在基线时完成了结构化电话访谈，并在 12 个月时完成了后续访谈，我们将其与药房记录相关联。我们使用单个问卷项目评估基线时与药物相关的经济负担，并通过问卷和补充依从性作为覆盖天数比例 (PDC) 评估 12 个月的依从性。三分之一的参与者（30.1%）报告了药物费用造成的经济负担。在调整后的线性回归模型中，有经济负担的参与者自我报告的依从性显着较低（β = − 0.29，95％CI -0.48至− 0.11），尽管这在PDC中并不明显（β = − 2.76，95％CI -5.65至0.14）。对于许多爱尔兰公共保险老年患者来说，这种共付额对坚持抗高血压治疗构成了经济障碍。依从性的负面影响可能会增加中风等不良后果的风险，并增加长期医疗费用。本文的在线版本 (10.1186/s12889-018-6209-8) 包含补充材料，可供授权用户使用。
Medication co-payments represent a financial barrier to antihypertensive medication adherence. The introduction of co-payments for Irish publically insured patients was associated with a 5% reduction in adherence. However there is socioeconomic variability within this population, and the impact may be greater for those on lower income. We evaluated medication-related financial burden of the co-payment in a cohort of Irish publically insured antihypertensive users and tested its association with adherence at 12 months. This was a prospective cohort study of community dwelling older (> 65 yrs) adults (n = 1152) from 106 Irish community pharmacies. Participants completed a structured telephone interview at baseline, and a follow-up interview at 12-months, which we linked to pharmacy records. We assessed medication-related financial burden at baseline using a single questionnaire item, and adherence at 12 months via questionnaire and refill-adherence as Proportion of Days Covered (PDC). A third of participants (30.1%) reported financial burden due to medication costs. In adjusted linear regression models financially burdened participants had significantly lower self-reported adherence (β = − 0.29, 95% CI -0.48 to − 0.11), although this was not evident with PDC (β = − 2.76, 95% CI -5.65 to 0.14). This co-payment represents a financial barrier to antihypertensive adherence for many older Irish publically insured patients. The negative impact to adherence will potentially increase the risk of adverse outcomes, such as stroke, and increase long-term healthcare costs. The online version of this article (10.1186/s12889-018-6209-8) contains supplementary material, which is available to authorized users.
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影响因子：
4
作者：
Garfield S;Clifford S;Eliasson L;Barber N;Willson A
通讯作者：
Willson A
影响因子：
--
作者：
Bramley, TJ;Gerbino, PP;Frech-Tamas, F
通讯作者：
Frech-Tamas, F
影响因子：
2.6
作者：
Hynd, Anna;Roughead, Elizabeth E.;Semmens, James
通讯作者：
Semmens, James
影响因子：
2.6
作者：
Andrade, Susan E.;Kahler, Kristijan H.;Chan, K. Arnold
通讯作者：
Chan, K. Arnold
影响因子：
--
作者：
Chapman, RH;Benner, JS;Schwartz, JS
通讯作者：
Schwartz, JS