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医疗保险受益癌症患者的处方药覆盖满意度和药物不依从性。

Prescription drug coverage satisfaction and medication nonadherence among Medicare beneficiaries with cancer.

机构信息

Department of Pharmacy and Health Systems Sciences, School of Pharmacy, Northeastern University, Boston, MA, USA.

College of Nursing, University of Central Florida, Orlando, Fl, Usa and Disability, Aging, and Technology Cluster, University of Central Florida, Orlando, FL, USA.

出版信息

Expert Rev Pharmacoecon Outcomes Res. 2022 Sep;22(6):971-979. doi: 10.1080/14737167.2022.2064846. Epub 2022 Apr 29.

Abstract

BACKGROUND

Medication nonadherence among older patients with cancer can have profound health consequences. This study examines the association between prescription drug coverage satisfaction and medication nonadherence among Medicare beneficiaries with cancer.

METHODS

We analyzed the 2017 Medicare Current Beneficiary Survey Public Use File of beneficiaries aged ≥65 years with reported non-skin cancer (n = 806). Beneficiaries were considered to have medication nonadherence if they reported: skipping doses, taking smaller doses than prescribed, or delaying or not filling a prescription because of cost. A survey-weighted logistic model, adjusted for covariates, was conducted to examine the association between prescription drug coverage satisfaction and medication nonadherence.

RESULTS

Of study beneficiaries with cancer, 14.7% reported medication nonadherence. Higher proportions of beneficiaries with medication nonadherence were dissatisfied with the amount paid for medications (33.2% vs. 11.0%, p < 0.001) and the medications included on formulary (29.5% vs 5.2%, p < 0.001). In the adjusted analysis, the risk for medication nonadherence was higher among those who were dissatisfied with the amount paid for medications (OR = 2.22; p = 0.050) and the medications included on formulary (OR = 5.03; p = 0.005).

CONCLUSIONS

Strategic mitigation of these barriers is essential to improving health outcomes in this at-risk population.

摘要

背景

老年癌症患者用药不依从可能会产生严重的健康后果。本研究考察了医疗保险受益人群中,与癌症相关的处方药覆盖满意度与用药不依从之间的关联。

方法

我们分析了 2017 年 Medicare 现期受益人调查公共使用文件中报告患有非皮肤癌的年龄≥65 岁的受益人的数据(n=806)。如果报告因费用而漏服、减少剂量、延迟或不服用处方药物,则认为受益人为用药不依从。采用调整了协变量的调查加权逻辑模型来考察处方药覆盖满意度与用药不依从之间的关联。

结果

在患有癌症的研究受益人群中,14.7%报告用药不依从。更多比例的用药不依从者对所付药物费用(33.2%比 11.0%,p<0.001)和纳入处方的药物种类(29.5%比 5.2%,p<0.001)不满意。在调整分析中,对所付药物费用(OR=2.22;p=0.050)和纳入处方的药物种类(OR=5.03;p=0.005)不满意的人群发生用药不依从的风险更高。

结论

为改善这一高危人群的健康结果,必须对这些障碍进行策略性缓解。

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