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dc.contributor.authorSoumerai, Stephen Bertram
dc.contributor.authorPierre-Jacques, Marsha
dc.contributor.authorZhang, Fang
dc.contributor.authorRoss-Degnan, Dennis
dc.contributor.authorAdams, Alyce S.
dc.contributor.authorGurwitz, Jerry
dc.contributor.authorAdler, Gerald
dc.contributor.authorSafran, Dana Gelb
dc.date.accessioned2017-05-16T19:09:15Z
dc.date.issued2006
dc.identifier.citationSoumerai, Stephen B., Marsha Pierre-Jacques, Fang Zhang, Dennis Ross-Degnan, Alyce S. Adams, Jerry Gurwitz, Gerald Adler, and Dana Gelb Safran. 2006. “Cost-Related Medication Nonadherence Among Elderly and Disabled Medicare Beneficiaries.” Archives of Internal Medicine 166 (17) (September 25): 1829. doi:10.1001/archinte.166.17.1829.en_US
dc.identifier.issn0003-9926en_US
dc.identifier.urihttp://nrs.harvard.edu/urn-3:HUL.InstRepos:32696168
dc.description.abstractBackground Prior to implementation of the Medicare drug benefit, we estimated the prevalence of cost-related medication nonadherence (CRN) among Medicare enrollees, including elderly and nonelderly disabled beneficiaries. Methods In the fall of 2004, detailed measures of CRN (skipping or reducing doses or not filling prescriptions because of cost) were added to the Medicare Current Beneficiary Survey. We examined the prevalence of CRN nationally and by Medicare eligibility subgroups (elderly vs nonelderly disabled beneficiaries), drug coverage status, socioeconomic status, self-rated health, and number of chronic medical conditions. Results In a national sample of 13 835 noninstitutionalized Medicare enrollees, 29% of the disabled and 13% of the elderly beneficiaries reported CRN; those in fair to poor health with multiple comorbidities and without coverage were most at risk. Among the disabled enrollees with 4 or more morbidities, 52% (95% confidence interval [CI], 43.3%-60.3%) without drug coverage skipped prescriptions or doses compared with 26% (95% CI, 17.7%-34.8%) with Medicaid drug coverage. Those with partial drug coverage through Medigap policies or Medicare health maintenance organizations reported intermediate rates of CRN. The adjusted odds ratio of CRN among disabled enrollees in poor (vs good) health was 3.9 (95% CI, 1.7-9.2), whereas for those with 4 or more (vs <4) comorbidities, the odds ratio of CRN was 2.7 (95% CI, 1.7-4.1). Conclusions One year before Medicare Part D implementation, Medicare beneficiaries reported high rates of CRN. Rates are highest among nonelderly disabled beneficiaries, but among both elderly and disabled beneficiaries, CRN is exacerbated by poor health, multiple morbidities, and limited drug coverage. Given the high cost sharing under Part D, it is important to closely monitor CRN in high-risk subgroups.en_US
dc.language.isoen_USen_US
dc.publisherAmerican Medical Association (AMA)en_US
dc.relation.isversionofdoi:10.1001/archinte.166.17.1829en_US
dash.licenseLAA
dc.titleCost-Related Medication Nonadherence Among Elderly and Disabled Medicare Beneficiariesen_US
dc.typeJournal Articleen_US
dc.description.versionVersion of Recorden_US
dc.relation.journalArchives of Internal Medicineen_US
dash.depositing.authorSoumerai, Stephen Bertram
dc.date.available2017-05-16T19:09:15Z
dc.identifier.doi10.1001/archinte.166.17.1829*
dash.contributor.affiliatedAdler, Gerald
dash.contributor.affiliatedZhang, Fang
dash.contributor.affiliatedRoss-Degnan, Dennis
dash.contributor.affiliatedSoumerai, Stephen


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