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Cost-related medication non-adherence among U.S. adults with diabetes

  • Author Footnotes
    1 Department of Systems and Information Engineering, 151 Engineers Way, Charlottesville, VA, United States.
    Hyojung Kang
    Footnotes
    1 Department of Systems and Information Engineering, 151 Engineers Way, Charlottesville, VA, United States.
    Affiliations
    Department of Systems and Information Engineering, School of Engineering, University of Virginia, Charlottesville, VA, United States
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  • Author Footnotes
    2 Department of Public Health Sciences, Hospital West, PO Box 800717, Charlottesville, VA, United States.
    Jennifer Mason Lobo
    Footnotes
    2 Department of Public Health Sciences, Hospital West, PO Box 800717, Charlottesville, VA, United States.
    Affiliations
    Department of Public Health Sciences, School of Medicine, University of Virginia, Charlottesville, VA, United States
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  • Author Footnotes
    2 Department of Public Health Sciences, Hospital West, PO Box 800717, Charlottesville, VA, United States.
    Soyoun Kim
    Footnotes
    2 Department of Public Health Sciences, Hospital West, PO Box 800717, Charlottesville, VA, United States.
    Affiliations
    Department of Public Health Sciences, School of Medicine, University of Virginia, Charlottesville, VA, United States
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  • Min-Woong Sohn
    Correspondence
    Corresponding author at: Department of Public Health Sciences, Hospital West, 3rd Floor, Room 3003, PO Box 800717, Charlottesville, VA 22908-0717, United States.
    Affiliations
    Department of Public Health Sciences, School of Medicine, University of Virginia, Charlottesville, VA, United States
    Search for articles by this author
  • Author Footnotes
    1 Department of Systems and Information Engineering, 151 Engineers Way, Charlottesville, VA, United States.
    2 Department of Public Health Sciences, Hospital West, PO Box 800717, Charlottesville, VA, United States.

      Abstract

      Aims

      To examine factors that affect cost-related medication non-adherence (CRN), defined as taking medication less than as prescribed because of cost, among adults with diabetes and to determine their relative contribution in explaining CRN.

      Methods

      Behavioral Risk Factor Surveillance System data for 2013–2014 were used to identify individuals with diabetes and their CRN. We modeled CRN as a function of financial factors, regimen complexity, and other contextual factors including diabetes care, lifestyle, and health factors. Dominance analysis was performed to rank these factors by relative importance.

      Results

      CRN among U.S. adults with diabetes was 16.5%. Respondents with annual income <$50,000 and without health insurance were more likely to report CRN, compared to those with income ≥$50,000 and those with insurance, respectively. Insulin users had 1.24 times higher risk of CRN compared to those not on insulin. Contextual factors that significantly affected CRN included diabetes care factors, lifestyle factors, and comorbid depression, arthritis, and COPD/asthma. Dominance analysis showed health insurance was the most important factor for respondents <65 and depression was the most important factor for respondents ≥65.

      Conclusions

      In addition to traditional risk factors of CRN, compliance with annual recommendations for diabetes and healthy lifestyle were associated with lower CRN. Policies and social supports that address these contextual factors may help improve CRN.

      Keywords

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