Relationship Between Medication Adherence and Distance to Dispensing Pharmacies and Prescribers Among an Urban Medicaid Population with Diabetes Mellitus.
Relationship Between Medication Adherence and Distance to Dispensing Pharmacies and Prescribers Among an Urban Medicaid Population with Diabetes Mellitus.
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DOI：
10.1002/phar.1757
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发表时间：
2016-06
期刊：
影响因子：
4.1
通讯作者：
Gerber BS
中科院分区：
文献类型：
--
作者：
Syed ST;Sharp LK;Kim Y;Jentleson A;Lora CM;Touchette DR;Berbaum ML;Suda KJ;Gerber BS
确定在城市糖尿病公共救助人群中，血管紧张素转换酶抑制剂(ACEI)和血管紧张素II受体阻滞剂(ARB)的药物依从性与距离药店和处方者的距离之间是否存在关系。使用索赔数据的回溯性队列研究。伊利诺伊州卫生保健和家庭服务部数据库。共有6,532名年龄在18-之间的糖尿病患者，他们至少有一张ACEI或ARB的处方药，并于2009年在大芝加哥地区连续享受医疗补助。对ACEI和ARB的用药依从性(定义为覆盖天数(PDC)≥0.8%)及其与患者与其药店和处方者之间的距离的相关性进行了评估。在纳入分析的6,532名患者中，2,930名(45%)的PDC水平为≥0.8。粘附者和非粘附者之间在距离药房的距离(中位数1.39比1.35英里，p=0.15)或到处方者的距离(中位数4.39比4.48英里，p=0.80)方面没有显著差异。在包括年龄、性别、种族、药房数量、处方医生数量、到药房的距离和与处方医生的距离的多变量回归模型中，更多的处方医生与更高的依从性相关(2名处方医生对1名处方医生：优势比[OR]1.396，95%可信区间[CI]1.233-1.580；≥3名处方医生对1名处方医生：OR 2.208，95%CI 1.787-2.727)。ACEI或ARB的依从性与距离药店和处方医生的距离无关。
To determine whether a relationship exists between medication adherence to angiotensin-converting enzyme inhibitors (ACEIs) and angiotensin II receptor blockers (ARBs) and distance to dispensing pharmacies and prescribers among an urban, public aid population with diabetes mellitus. Retrospective cohort study using claims data. Illinois Department of Healthcare and Family Services database. A total of 6532 patients aged 18–64 years with diabetes who had at least one prescription fill for an ACEI or ARB, and had continuous Medicaid coverage in the greater Chicago area in 2009. Medication adherence, defined as proportion of days covered (PDC) ≥ 0.8, to ACEIs and ARBs and its association with distances between patients and their pharmacies and prescribers was assessed. Of the 6532 patients included in the analyses, 2930 (45%) had PDC levels ≥ 0.8. No significant differences were observed between patients who were adherent versus those who were nonadherent in distance to pharmacy (median 1.39 vs 1.35 miles, p=0.15) or distance to prescriber (median 4.39 vs 4.48 miles, p=0.80). In a multivariate regression model including age, sex, race-ethnicity, number of pharmacies, number of prescribers, distance to pharmacy, and distance to prescriber, a greater number of prescribers was associated with higher adherence (2 prescribers vs 1 prescriber: odds ratio [OR] 1.396, 95% confidence interval [CI] 1.233–1.580; ≥ 3 prescribers vs 1 prescriber: OR 2.208, 95% CI 1.787–2.727). ACEI or ARB adherence was not associated with distances to pharmacies and prescribers.