Cost-related nonadherence to medicines in people with multiple chronic conditions

Laba, T-L; Cheng, L; Kolhatkar, A; Law, MR

Cost-related nonadherence to medicines in people with multiple chronic conditions

Laba, T-L Cheng, L Kolhatkar, A Law, MR

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Publisher:: Elsevier BV
Publication Type:: Journal Article
Citation:: Research in Social & Administrative Pharmacy : RSAP, 2020, 16, (3), pp. 415-421
Issue Date:: 2020

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Field	Value	Language
dc.contributor.author	Laba, T-L
dc.contributor.author	Cheng, L
dc.contributor.author	Kolhatkar, A
dc.contributor.author	Law, MR
dc.date.accessioned	2020-10-01T22:59:19Z
dc.date.available	2019-06-18
dc.date.available	2020-10-01T22:59:19Z
dc.date.issued	2020
dc.identifier.citation	Research in Social & Administrative Pharmacy : RSAP, 2020, 16, (3), pp. 415-421
dc.identifier.issn	1551-7411
dc.identifier.issn	1934-8150
dc.identifier.uri	http://hdl.handle.net/10453/142985
dc.description.abstract	BACKGROUND:Multimorbidity is common and frequently associated with medicine nonadherence. Although cost is a common reason for nonadherence, very little research has quantified cost-related nonadherence (CRNA) to medicines specifically in people with multimorbidity, the prevalence of CRNA for different conditions nor the impact of cost when prioritising treatment between conditions. OBJECTIVE:To determine the extent of CRNA in people with multimorbidity and the patient characteristics associated with these behaviours. DESIGN AND SETTING:People reporting two or more chronic conditions responding to a rapid response module regarding prescription drug affordability fielded between January 1 and June 30 2016 in the Canadian Community Health Survey, a cross-sectional household survey. METHODS:Ordinal logistic regression, adjusted for key sociodemographic, clinical and treatment related variables, of weighted population estimates of self-reported CRNA within one group of conditions, across multiple groups of conditions, or no CRNA. RESULTS:10.2% of 8420 Canadians with multimorbidity reported CRNA. The majority (61%) reported CRNA within one group of conditions, especially respiratory (16%) and mental health disorders (17%). CRNA was more common in younger adults, people without employer or association drug insurance plans, poorer health status, more chronic conditions, and increased out-of-pocket prescription costs. Having no prescription insurance was associated with a higher probability of CRNA across multiple groups of conditions. CONCLUSIONS:People with multimorbidity primarily forego medicines because of cost within one group of conditions. However, those without drug insurance extended these behaviours to multiple condition groups. Further work is needed to determine how people prioritise the conditions and treatments that are foregone because of cost, and how to best incorporate this information into treatment plans.
dc.format	Print-Electronic
dc.language	eng
dc.publisher	Elsevier BV
dc.relation	http://purl.org/au-research/grants/nhmrc/APP1110230
dc.relation	http://purl.org/au-research/grants/nhmrc/GNT1110230
dc.relation.ispartof	Research in Social & Administrative Pharmacy : RSAP
dc.relation.isbasedon	10.1016/j.sapharm.2019.06.008
dc.rights	info:eu-repo/semantics/closedAccess
dc.subject	1115 Pharmacology and Pharmaceutical Sciences, 1117 Public Health and Health Services
dc.subject.classification	Pharmacology & Pharmacy
dc.title	Cost-related nonadherence to medicines in people with multiple chronic conditions
dc.type	Journal Article
utslib.citation.volume	16
utslib.location.activity	United States
utslib.for	1117 Public Health and Health Services
utslib.for	1115 Pharmacology and Pharmaceutical Sciences
utslib.for	1115 Pharmacology and Pharmaceutical Sciences
utslib.for	1117 Public Health and Health Services
pubs.organisational-group	/University of Technology Sydney/Faculty of Business
pubs.organisational-group	/University of Technology Sydney/Strength - CHERE - Centre for Health Economics Research and Evaluation
pubs.organisational-group	/University of Technology Sydney
utslib.copyright.status	closed_access	*
pubs.consider-herdc	true
dc.date.updated	2020-10-01T22:59:01Z
pubs.issue	3
pubs.publication-status	Published
pubs.volume	16
utslib.citation.issue	3

Abstract:

BACKGROUND:Multimorbidity is common and frequently associated with medicine nonadherence. Although cost is a common reason for nonadherence, very little research has quantified cost-related nonadherence (CRNA) to medicines specifically in people with multimorbidity, the prevalence of CRNA for different conditions nor the impact of cost when prioritising treatment between conditions. OBJECTIVE:To determine the extent of CRNA in people with multimorbidity and the patient characteristics associated with these behaviours. DESIGN AND SETTING:People reporting two or more chronic conditions responding to a rapid response module regarding prescription drug affordability fielded between January 1 and June 30 2016 in the Canadian Community Health Survey, a cross-sectional household survey. METHODS:Ordinal logistic regression, adjusted for key sociodemographic, clinical and treatment related variables, of weighted population estimates of self-reported CRNA within one group of conditions, across multiple groups of conditions, or no CRNA. RESULTS:10.2% of 8420 Canadians with multimorbidity reported CRNA. The majority (61%) reported CRNA within one group of conditions, especially respiratory (16%) and mental health disorders (17%). CRNA was more common in younger adults, people without employer or association drug insurance plans, poorer health status, more chronic conditions, and increased out-of-pocket prescription costs. Having no prescription insurance was associated with a higher probability of CRNA across multiple groups of conditions. CONCLUSIONS:People with multimorbidity primarily forego medicines because of cost within one group of conditions. However, those without drug insurance extended these behaviours to multiple condition groups. Further work is needed to determine how people prioritise the conditions and treatments that are foregone because of cost, and how to best incorporate this information into treatment plans.

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http://hdl.handle.net/10453/142985