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Financial Strain and Medication Adherence among Diabetes Patients in an Integrated Health Care Delivery System: The Diabetes Study of Northern California (DISTANCE)
- Lyles, Courtney R;
- Seligman, Hilary K;
- Parker, Melissa M;
- Moffet, Howard H;
- Adler, Nancy;
- Schillinger, Dean;
- Piette, John D;
- Karter, Andrew J
Published Web Location
https://doi.org/10.1111/1475-6773.12346Abstract
OBJECTIVE: To examine self-reported financial strain in relation to pharmacy utilization adherence data. DATA SOURCES/STUDY SETTING: Survey, administrative, and electronic medical data from Kaiser Permanente Northern California. STUDY DESIGN: Retrospective cohort design (2006, n = 7,773). DATA COLLECTION/EXTRACTION METHODS: We compared survey self-reports of general and medication-specific financial strain to three adherence outcomes from pharmacy records, specifying adjusted generalized linear regression models. PRINCIPAL FINDINGS: Eight percent and 9 percent reported general and medication-specific financial strain. In adjusted models, general strain was significantly associated with primary nonadherence (RR = 1.37; 95 percent CI: 1.04-1.81) and refilling late (RR = 1.34; 95 percent CI: 1.07-1.66); and medication-specific strain was associated with primary nonadherence (RR = 1.42, 95 percent CI: 1.09-1.84). CONCLUSIONS: Simple, minimally intrusive questions could be used to identify patients at risk of poor adherence due to financial barriers.
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