Department of Statistics and Data Science, University of Central Florida, Orlando.
Department of Pharmacy and Health Systems Sciences, School of Pharmacy, Northeastern University, Boston, MA.
J Manag Care Spec Pharm. 2021 Jun;27(6):696-705. doi: 10.18553/jmcp.2021.27.6.696.
Medication nonadherence in individuals with type 2 diabetes can lead to poor glycemic control, resulting in increased risk for diabetes-related complications. To examine associations between factors (ie, drug coverage satisfaction and cost-reducing behavior) and medication nonadherence among Medicare beneficiaries with type 2 diabetes. We analyzed the 2016 Medicare Current Beneficiary Survey Public Use File for beneficiaries aged 65 years and older with reported type 2 diabetes (n=1,430; weighted n=5,846,943). Medicare beneficiaries were considered to have medication nonadherence if they reported skipping doses or taking smaller doses than prescribed. A survey-weighted logistic model, adjusted for sociodemographics and comorbidities, was conducted to examine associations of drug coverage satisfaction and cost-reducing behavior with medication nonadherence. Among Medicare beneficiaries aged 65 years and older with type 2 diabetes, 10.3% reported medication nonadherence. In the adjusted analysis, the risk for medication nonadherence was higher among those who were dissatisfied with the amount paid for medications (OR = 2.43; = 0.002) compared with those who were satisfied, and those who spent less on basic needs to save for medications were more likely to report medication nonadherence (OR = 2.23; = 0.011) than those who did not. Our findings suggest that medication nonadherence among Medicare beneficiaries with type 2 diabetes is associated with dissatisfaction with the amount paid for medications and cost-reducing behavior. Interventions that lower medication costs for Medicare beneficiaries may help to improve medication adherence among this at-risk population. No outside funding supported this study. The authors have no conflicts of interest to disclose.
2 型糖尿病患者的药物治疗依从性差可导致血糖控制不佳，从而增加糖尿病相关并发症的风险。本研究旨在探讨 2 型糖尿病 Medicare 受益人群中药物治疗依从性与药物覆盖满意度和降低成本行为之间的关系。我们分析了 2016 年 Medicare 现收现付调查公共使用文件中年龄在 65 岁及以上、报告患有 2 型糖尿病的受益人群（n=1430；加权 n=5846943）。如果报告漏服或服用的剂量小于规定剂量，则认为 Medicare 受益人群存在药物治疗依从性差。采用校正了社会人口统计学和合并症的调查加权逻辑模型，来检验药物覆盖满意度和降低成本行为与药物治疗依从性之间的关系。在年龄在 65 岁及以上、患有 2 型糖尿病的 Medicare 受益人群中，有 10.3%报告药物治疗依从性差。在调整分析中，与药物治疗满意度高的人群相比，对所付药物金额不满意的人群发生药物治疗依从性差的风险更高（OR=2.43；P=0.002），为节省药物费用而减少基本生活支出的人群更有可能报告药物治疗依从性差（OR=2.23；P=0.011）。研究结果表明，2 型糖尿病 Medicare 受益人群的药物治疗依从性差与对所付药物金额的不满意和降低成本行为有关。降低 Medicare 受益人群药物费用的干预措施可能有助于改善该高危人群的药物治疗依从性。本研究无外部资金支持。作者无利益冲突。
