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Factors affecting cost-related medication non-adherence among US population with cardiovascular risk factors
Nikhila Gandrakota1,2, Manju Ramakrishnan3, Kavya Sudireddy4
1Emory University School of Medicinehttps://ror.org/03czfpz43, Atlanta, USA.
Insights
Cost-related medication non-adherence (CRMN) disproportionately affects younger adults with cardiovascular disease (CVD) risk factors and lacking insurance. Targeted interventions and improved prescription drug coverage are crucial for this vulnerable population.
Area of Science:
- Public Health
- Epidemiology
- Health Services Research
Background:
- Cardiovascular diseases (CVD) are a leading cause of mortality and morbidity in the United States.
- Cost-related medication non-adherence (CRMN) significantly exacerbates CVD outcomes.
- Understanding the demographics and risk factors associated with CRMN is critical for effective public health strategies.
Purpose of the Study:
- To investigate the association between cardiovascular disease (CVD) risk factors and cost-related medication non-adherence (CRMN) in US adults.
- To identify specific demographic and socioeconomic factors that increase the risk of CRMN.
- To inform targeted interventions aimed at reducing CRMN among high-risk populations.
Main Methods:
- Utilized data from the 2019-2021 National Health Interview Survey (NHIS) encompassing 49,464 US adults.
- Employed chi-square tests and logistic regression analyses to identify factors associated with CRMN.
- Categorized participants based on reported CVD risk factors for stratified analysis.
Main Results:
- Younger adults (<65), unmarried individuals, females, those with lower education levels, and residents of the South reported higher CRMN.
- Current smokers and individuals with multiple CVD risk factors exhibited increased CRMN.
- Higher income, older age (≥65), excellent self-rated health, and public insurance (including Medicaid) were associated with lower CRMN compared to uninsured individuals.
Conclusions:
- Adults under 65 with multiple CVD risk factors and lacking health insurance are at elevated risk for CRMN.
- Enhancing prescription drug coverage and implementing targeted interventions are essential to mitigate CRMN in individuals with cardiovascular risk factors.
- Addressing socioeconomic disparities is crucial for reducing medication non-adherence and improving CVD outcomes.
Introduction:
In the US, cardiovascular diseases (CVD) are the leading cause of death and disability. Cost-related medication non-adherence (CRMN) can have serious consequences and worsen CVD outcomes. We examined the relationship between CVD risk factors and CRMN among US adults.
Methods:
CDC's 2019-2021 National Health Interview Survey (NHIS) data were used to examine CRMN among adults, categorized into three groups based on reported risk factors. We used chi-square tests, and logistic regression to determine factors associated with CRMN.
Results:
Among 49,464 participants, young, unmarried individuals, females, less educated, and participants from the South had higher CRMN than older, married individuals, males, and those with higher education residing in the other regions. Current smokers and those with more CVD risk factors also reported higher CRMN than former and never-smokers. Conversely, those aged 65 or older, with high-income, and excellent self-rated health had lower CRMN than younger participants, low-income families, and those with poor self-rated health. Public insurance and Medicaid participants had lower CRMN than uninsured (OR 0.13, 95% CI, 0.04-0.45, and OR 0.24, 95% CI, 0.15-0.36). Stratified analysis by diabetes, hypertension, and hyperlipidemia, revealed participants with high-income had lower odds of CRMN (OR 0.38, 95% CI, 0.28-0.50; OR 0.39, 95% CI, 0.28-0.58; OR 0.37, 95% CI, 0.27-0.51 respectively) than those with lower- incomes.
Conclusion:
Adults under 65 with more CVD risk factors and lacking insurance coverage are at higher risk of CRMN. Therefore, strengthening prescription drug coverage and targeted interventions are necessary to reduce CRMN among those with cardiovascular risk factors.
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