Access and cost-related non-adherence to prescription medications among lupus cases and controls: the Michigan Lupus Epidemiology & Surveillance (MILES) Program

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@article{74da4b4ac7e24418b4938f1cc6604dab,
title = "Access and cost-related non-adherence to prescription medications among lupus cases and controls: the Michigan Lupus Epidemiology & Surveillance (MILES) Program",
abstract = "Background: Medication access and adherence are important determinants of health outcomes. We investigated factors associated with access and cost-related non-adherence to prescriptions in a population-based cohort of systemic lupus erythematosus (SLE) patients and controls. Methods: Detailed sociodemographic and prescription data were collected by structured interview in 2014-2015 from participants in the Michigan Lupus Epidemiology & Surveillance (MILES) Cohort. We compared access between cases and frequency-matched controls and examined associated factors in separate multivariable logistic regression models. Results: 654 participants (462 SLE cases, 192 controls) completed the baseline visit; 584 (89%) were female, 285 (44%) black, and mean age was 53 years. SLE cases and controls reported similar frequencies of being unable to access prescribed medications (12.1% vs 9.4%, respectively; p=NS). SLE patients were twice as likely as controls to report cost-related prescription non-adherence in the preceding 12 months to save money (21.7% vs 10.4%; p=0.001), but also more likely to ask their doctor for lower cost alternatives (23.8% vs 15.6%, p=0.02). Disparities were found in association with income, race and health insurance status, but main findings persisted after adjusting for these and other variables in multivariable models. Conclusion: SLE patients were more likely than controls from the general population to report cost-related prescription non-adherence, including skipping doses, taking less medicine and delaying filling prescriptions, yet less than 1 in 4 patients asked providers for lower cost medications. Consideration of medication costs in patient decision-making could provide a meaningful avenue for improving access and adherence to medications. ",
author = "Caroline Gordon",
year = "2020",
month = jul,
day = "31",
doi = "10.1002/acr.24397",
language = "English",
journal = "Arthritis Care & Research",
issn = "2151-464X",
publisher = "Wiley",

}

RIS

TY - JOUR

T1 - Access and cost-related non-adherence to prescription medications among lupus cases and controls: the Michigan Lupus Epidemiology & Surveillance (MILES) Program

AU - Gordon, Caroline

PY - 2020/7/31

Y1 - 2020/7/31

N2 - Background: Medication access and adherence are important determinants of health outcomes. We investigated factors associated with access and cost-related non-adherence to prescriptions in a population-based cohort of systemic lupus erythematosus (SLE) patients and controls. Methods: Detailed sociodemographic and prescription data were collected by structured interview in 2014-2015 from participants in the Michigan Lupus Epidemiology & Surveillance (MILES) Cohort. We compared access between cases and frequency-matched controls and examined associated factors in separate multivariable logistic regression models. Results: 654 participants (462 SLE cases, 192 controls) completed the baseline visit; 584 (89%) were female, 285 (44%) black, and mean age was 53 years. SLE cases and controls reported similar frequencies of being unable to access prescribed medications (12.1% vs 9.4%, respectively; p=NS). SLE patients were twice as likely as controls to report cost-related prescription non-adherence in the preceding 12 months to save money (21.7% vs 10.4%; p=0.001), but also more likely to ask their doctor for lower cost alternatives (23.8% vs 15.6%, p=0.02). Disparities were found in association with income, race and health insurance status, but main findings persisted after adjusting for these and other variables in multivariable models. Conclusion: SLE patients were more likely than controls from the general population to report cost-related prescription non-adherence, including skipping doses, taking less medicine and delaying filling prescriptions, yet less than 1 in 4 patients asked providers for lower cost medications. Consideration of medication costs in patient decision-making could provide a meaningful avenue for improving access and adherence to medications.

AB - Background: Medication access and adherence are important determinants of health outcomes. We investigated factors associated with access and cost-related non-adherence to prescriptions in a population-based cohort of systemic lupus erythematosus (SLE) patients and controls. Methods: Detailed sociodemographic and prescription data were collected by structured interview in 2014-2015 from participants in the Michigan Lupus Epidemiology & Surveillance (MILES) Cohort. We compared access between cases and frequency-matched controls and examined associated factors in separate multivariable logistic regression models. Results: 654 participants (462 SLE cases, 192 controls) completed the baseline visit; 584 (89%) were female, 285 (44%) black, and mean age was 53 years. SLE cases and controls reported similar frequencies of being unable to access prescribed medications (12.1% vs 9.4%, respectively; p=NS). SLE patients were twice as likely as controls to report cost-related prescription non-adherence in the preceding 12 months to save money (21.7% vs 10.4%; p=0.001), but also more likely to ask their doctor for lower cost alternatives (23.8% vs 15.6%, p=0.02). Disparities were found in association with income, race and health insurance status, but main findings persisted after adjusting for these and other variables in multivariable models. Conclusion: SLE patients were more likely than controls from the general population to report cost-related prescription non-adherence, including skipping doses, taking less medicine and delaying filling prescriptions, yet less than 1 in 4 patients asked providers for lower cost medications. Consideration of medication costs in patient decision-making could provide a meaningful avenue for improving access and adherence to medications.

U2 - 10.1002/acr.24397

DO - 10.1002/acr.24397

M3 - Article

JO - Arthritis Care & Research

JF - Arthritis Care & Research

SN - 2151-464X

ER -