Cost-Related Medication Nonadherence Among Older Adults: Findings From a Nationally Representative Sample
Chung, G.C.; Marottoli, R.A.; Cooney, L.M.; Rhee, T.Greg.
Journal of the American Geriatrics Society 67(12): 2463-2473
ISSN/ISBN: 0002-8614 PMID: 31437309 DOI: 10.1111/jgs.16141
To estimate the rate of and risk factors associated with cost-related medication nonadherence among older adults. Cross-sectional analysis of the 2017 National Health Interview Survey (NHIS). Nationally representative health interview survey in the United States. Survey respondents, aged 65 years or older (n = 5701 unweighted) in the 2017 wave of the NHIS. Self-reported, cost-related medication nonadherence (due to cost: skip dose, reduce dose, or delay or not fill a prescription) and actions taken due to cost-related medication nonadherence (ask for lower-cost prescription, use alternative therapy, or buy medications from another country) were quantified. We used a series of multivariable logistic regression analyses to identify factors associated with cost-related medication nonadherence. We also reported analyses by chronic disease subgroups. In 2017, 408 (6.8%) of 5901 older adults, representative of 2.7 million older adults nationally, reported cost-related medication nonadherence. Among those with cost-related medication nonadherence, 44.2% asked a physician for lower-cost medications, 11.5% used alternative therapies, and 5.3% bought prescription drugs outside the United States to save money. Correlates independently associated with a higher likelihood of cost-related medication nonadherence included: younger age, female sex, lower socioeconomic levels (eg, low income and uninsured), mental distress, functional limitations, multimorbidities, and obesity (P < .05 for all). Similar patterns were found in subgroup analyses. Cost-related medication nonadherence among older adults is increasingly common, with several potentially modifiable risk factors identified. Interventions, such as medication therapy management, may be needed to reduce cost-related medication nonadherence in older adults. J Am Geriatr Soc 67:2463-2473, 2019.