Ali Asma M, Cobran Ewan K, Young Henry N
Department of Family Medicine and Community Health, University of Wisconsin-Madison, 1100 Delaplaine Ct., Madison, WI 53715, USA.
Department of Clinical and Administrative Pharmacy, University of Georgia College of Pharmacy, Athens, GA 30602, USA.
Pharmacy (Basel). 2022 Jul 8;10(4):79. doi: 10.3390/pharmacy10040079.
This study describes access to prescription medications and examines personal, financial, and structural barriers associated with access to prescription medications in patients with type 2 diabetes treated at Federally Qualified Health Centers. We used a cross-sectional design to analyze data retrieved from the 2014 Health Center Patient Survey. Adult participants who self-reported having type 2 diabetes were included in this study. Predictor variables were categorized into personal, financial, and structural barriers. Outcomes include being unable to get and delayed in getting prescription medications. Chi-square and multivariable regression models were conducted to examine associations between predictor and outcome variables. A total of 1097 participants with type 2 diabetes were included in analyses. Approximately 29% of participants were delayed, and 24% were unable to get medications. Multivariable regression results showed that personal barriers, such as federal poverty level, health status, and psychological distress were associated with being unable to get medications. Financial barriers including out-of-pocket medication cost and employment were associated with access to prescription medications. Type of health center funding program as a structural barrier was associated with access to medications. In conclusion, multi-level tailored strategies and policy changes are needed to address these barriers to improve access to prescription medications and health outcomes in underserved patient populations.
本研究描述了获得处方药物的情况,并调查了在联邦合格健康中心接受治疗的2型糖尿病患者中,与获得处方药物相关的个人、财务和结构障碍。我们采用横断面设计来分析从2014年健康中心患者调查中检索到的数据。自我报告患有2型糖尿病的成年参与者被纳入本研究。预测变量分为个人、财务和结构障碍。结果包括无法获得处方药物和获得处方药物延迟。采用卡方检验和多变量回归模型来检验预测变量和结果变量之间的关联。共有1097名2型糖尿病参与者纳入分析。约29%的参与者获得药物延迟,24%的参与者无法获得药物。多变量回归结果显示,个人障碍,如联邦贫困水平、健康状况和心理困扰,与无法获得药物有关。财务障碍,包括自付药费和就业情况,与获得处方药物有关。作为结构障碍的健康中心资金项目类型与获得药物有关。总之,需要采取多层次的针对性策略和政策变革来解决这些障碍,以改善在服务不足的患者群体中获得处方药物的情况和健康结局。