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Does Cost-Related Medication Nonadherence among Cardiovascular Disease Patients Vary by Gender? Evidence
Soumitra S Bhuyan1, Olayinka Shiyanbola2, Satish Kedia1
1School of Public Health, The University of Memphis, Memphis, Tennessee.
Insights
Women with cardiovascular disease (CVD) are 54% more likely to experience cost-related nonadherence (CRN) to medications than men. This highlights a need for targeted support for women facing financial barriers to medication adherence.
Area of Science:
- Health Services Research
- Public Health
- Cardiology
Background:
- Cardiovascular disease (CVD) poses a significant health burden in the U.S.
- Cost-related nonadherence (CRN) to prescribed medications is prevalent among CVD patients.
- Understanding gender disparities in CRN is crucial for effective patient management.
Purpose of the Study:
- To investigate gender differences in cost-related nonadherence (CRN) among patients with cardiovascular disease (CVD).
Main Methods:
- Utilized 2011-2014 National Health Interview Survey data.
- Employed multivariate logistic regressions based on Andersen's model of health services utilization.
- Defined CRN as skipping doses, taking less medication, or delaying prescription refills to save money.
Main Results:
- 10.0% of CVD patients skipped doses, 10.6% took less medication, and 12.8% delayed refills.
- After adjusting for confounders, women were 1.54 times more likely than men to exhibit any form of CRN.
- Significant gender disparities in CRN were observed in the CVD patient population.
Conclusions:
- Significant gender disparities in CRN exist among CVD patients.
- Targeted support and monitoring for CRN are essential, particularly for women with limited resources.
- Addressing financial barriers to medication adherence is critical for improving CVD outcomes.
Introduction:
Cardiovascular disease (CVD) is a leading cause of death and disability as well as a major burden on the U.S. healthcare system. Cost-related medication nonadherence (CRN) to prescribed medications is common among patients with CVD. This study examines the gender differences in CRN among CVD patients.
Methods:
We used 2011 to 2014 data from the National Health Interview Survey, an annual, cross-sectional, nationally representative household survey of the noninstitutionalized U.S. civilian population (≥18 years of age). Based on Andersen's model of health services utilization, multivariate logistic regressions were estimated to examine the effect of gender on the primary composite outcome of CRN which was identified if any of the following types of CRN were reported: 1) skipped medication doses to save money, 2) took less medication to save money, and 3) delayed prescription filling to save money.
Results:
Among CVD patients who had used a prescription medication in the last 12 months, 10.0% skipped medication doses, 10.6% took less medication, and 12.8% delayed filling their prescriptions. After adjusting for confounding factors, gender was found to be significantly associated with the composite outcome of CRN among CVD patients. Women were 1.54 times (95% confidence interval, 1.33-1.77) more likely to have any of the types of CRN compared with men.
Conclusion:
There are significant gender disparities in CRN among CVD patients. More support for and closer monitoring of CRN is needed for disadvantaged groups, especially women with limited resources.
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