+ Site Statistics
+ Search Articles
+ PDF Full Text Service
How our service works
Request PDF Full Text
+ Follow Us
Follow on Facebook
Follow on Twitter
Follow on LinkedIn
+ Subscribe to Site Feeds
Most Shared
PDF Full Text
+ Translate
+ Recently Requested

Reliability of new measures of cost-related medication nonadherence

Reliability of new measures of cost-related medication nonadherence

Medical Care 46(4): 444-448

Although several national studies have attempted to measure medication nonadherence due to cost in cross-sectional studies of the elderly and disabled, little information exists on the psychometric properties of these measures over time. Examine the test-retest reliability of several recently published measures of cost-related medication nonadherence, among elderly community. We developed a questionnaire and tested the reliability of measures of cost-related medication nonadherence and general cost-reduction strategies in a sample of 185 elderly in eastern Massachusetts surveyed twice (1-2 months apart). General and medicine-specific cost-related nonadherence measures included: failure to fill or delayed refilling of a prescription due to its cost, skipping doses, or taking smaller doses to make a medicine last longer. We also tested the reliability of reported drug cost-reduction strategies, such as: using generic drugs; purchasing prescriptions via mail/internet or from outside the United States; receiving prescription samples from a doctor; and spending less on food, heat, or other basic needs to afford medicines. We used the McNemar test, a matched pair chi analysis, and Kappa statistics to examine the association of responses within patients between identical items asked at 2 points in time. Kappa statistics for test-retest reliability ranged from 0.6 to 0.9 for all but one measure of cost-related nonadherence, and McNemar test statistics indicated no systematic change in the measures over time. The estimated test-retest reliability of the measures of cost-related medication nonadherence were generally high. The measures have been integrated into the nationally representative Medicare Current Beneficiary Survey (MCBS), an ongoing national panel survey of Medicare beneficiaries, which will allow researchers and policymakers to identify changes in cost-related nonadherence among disabled and elderly Medicare beneficiaries.

Please choose payment method:

(PDF emailed within 0-6 h: $19.90)

Accession: 055478828

Download citation: RISBibTeXText

PMID: 18362826

DOI: 10.1097/mlr.0b013e31815dc59a

Related references

Medication therapy management and cost-related medication nonadherence. JAMA 300(10): 1130; Author Reply 1130-1, 2008

Cost-related medication nonadherence and cost-saving strategies used by elderly Medicare cancer survivors. Journal of Cancer Survivorship 5(4): 395-404, 2011

Cost-Related Medication Nonadherence and Cost-Saving Behaviors Among Patients With Glaucoma Before and After the Implementation of Medicare Part D. JAMA Ophthalmology 133(9): 985-996, 2015

Clinical outcomes and incremental costs from a medication adherence pilot intervention targeting low-income patients with diabetes at risk of cost-related medication nonadherence. Clinical Therapeutics 36(12): 1991-2002, 2014

A pilot study on cost-related medication nonadherence in Ontario. Journal of Population Therapeutics and Clinical Pharmacology 19(2): E239, 2012

Depression and cost-related medication nonadherence in Medicare beneficiaries. Archives of General Psychiatry 64(5): 602-608, 2007

Cost-related medication nonadherence among beneficiaries with depression following Medicare Part D. American Journal of Geriatric Psychiatry 17(12): 1068-1076, 2009

Using Cost-Related Medication Nonadherence to Assess Social and Health Policies. American Journal of Public Health 108(2): 168-170, 2018

Patients at-risk for cost-related medication nonadherence: a review of the literature. Journal of General Internal Medicine 22(6): 864-871, 2007

Cost-related immunosuppressive medication nonadherence among kidney transplant recipients. Clinical Journal of the American Society of Nephrology 5(12): 2323-2328, 2010

Cost-related medication nonadherence in older patients with rheumatoid arthritis. Journal of Rheumatology 40(2): 137-143, 2013

Cost-related medication nonadherence among elderly emergency department patients. American Journal of Emergency Medicine 2019:, 2019

The Role of Gender in Cost-Related Medication Nonadherence Among Patients with Diabetes. Journal of the American Board of Family Medicine 31(5): 743-751, 2018

Risk for cost-related medication nonadherence among emergency department patients. Academic Emergency Medicine 18(3): 267-272, 2011

Medicare Part D coverage gap: race, gender, and cost-related medication nonadherence. Social Work in Public Health 30(6): 473-485, 2015