老年糖尿病患者中与费用相关的药物治疗不依从的风险因素。
Risk factors for cost-related medication non-adherence among older patients with diabetes.
作者信息
Zhang James X, Lee Jhee U, Meltzer David O
机构信息
James X Zhang, Jhee U Lee, David O Meltzer, Section of Hospital Medicine, Department of Medicine, the University of Chicago, Chicago, IL 60637, United States.
出版信息
World J Diabetes. 2014 Dec 15;5(6):945-50. doi: 10.4239/wjd.v5.i6.945.
Abstract
AIM
To assess the risk factors for cost-related medication non-adherence (CRN) among older patients with diabetes in the United States.
METHODS
We used data from the 2010 Health and Retirement Study to assess risk factors for CRN including age, drug insurance coverage, nursing home residence, functional limitations, and frequency of hospitalization. CRN was self-reported. We conducted multivariate regression analysis to assess the effect of each risk factor.
RESULTS
Eight hundred and seventy-five (18%) of 4880 diabetes patients reported CRN. Age less than 65 years, lack of drug insurance coverage, and frequent hospitalization significantly increased risk for CRN. Limitation in both activities of daily living and instrumental activities of daily living were also generally associated with increased risk of CRN. Residence in a nursing home and Medicaid coverage significantly reduced risk.
CONCLUSION
These results suggest that expanding prescription coverage to uninsured, sicker, and community-dwelling individuals is likely to produce the largest decreases in CRN.
摘要
目的
评估美国老年糖尿病患者中与费用相关的药物治疗不依从性（CRN）的风险因素。
方法
我们使用了2010年健康与退休研究的数据来评估CRN的风险因素，包括年龄、药物保险覆盖范围、养老院居住情况、功能受限以及住院频率。CRN通过自我报告获得。我们进行了多变量回归分析以评估每个风险因素的影响。
结果
4880名糖尿病患者中有875名（18%）报告了CRN。年龄小于65岁、缺乏药物保险覆盖范围以及频繁住院显著增加了CRN的风险。日常生活活动和工具性日常生活活动的受限通常也与CRN风险增加相关。居住在养老院和医疗补助覆盖范围显著降低了风险。
结论
这些结果表明，将处方覆盖范围扩大到未参保、病情较重且居住在社区的个体可能会使CRN的降幅最大。
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