Hypertension Medication and Medicare Beneficiaries: Prescription Drug Coverage Satisfaction and Medication Non-Adherence among Older Adults

Author:

Park Jeong-Hui1ORCID,Kim Kiyoung1ORCID,Medina Mar2ORCID,Ng Boon Peng3ORCID,Smith Matthew Lee145ORCID,Edafetanure-Ibeh Okeoghene Marcel1,Chang Jongwha6ORCID

Affiliation:

1. School of Public Health, Texas A&M Health Science Center, 212 Adriance Lab Rd., College Station, TX 77843, USA

2. School of Pharmacy, University of Texas at El Paso, 1101 N campbell St., El Paso, TX 79902, USA

3. College of Nursing, University of Central Florida, 12201 Research Parkway, Orlando, FL 32826, USA

4. Center for Health Equity and Evaluation Research, Texas A&M Health Science Center, 212 Adriance Lab Rd., College Station, TX 77843, USA

5. Center for Community Health and Aging, Texas A&M Health Science Center, 212 Adriance Lab Rd., College Station, TX 77843, USA

6. Irma Lerma Rangel School of Pharmacy, Texas A&M Health Science Center, 159 Reynolds Medical, College Station, TX 77843, USA

Abstract

Hypertension is so prevalent and requires strict adherence to medications to prevent further disease or death, but there is no study examining factors related to prescription drug non-adherence among 65 years old and older. This study aims to assess the likelihood of medication nonadherence among patients based on factors such as age, race, and socioeconomic status, with the goal of identifying strategies to enhance medication adherence and mitigate associated health risks. Using the 2020 Medicare Current Beneficiary Survey Public Use File to represent nationwide Medicare beneficiaries (unweighted n = 3917, weighted n = 27,134,782), medication non-adherence was related to multiple independent variables (i.e., age, sex, race/ethnicity, socioeconomic status, comorbidities, insurance coverage, and satisfaction with insurance). Cross-tabulations and Wald chi-square tests were used to determine how much each variable was related to non-adherence. Multivariate logistic regression was used to examine the association between medication non-adherence and factors such as prescription drug coverage satisfaction and cost-reducing behavior. Specific trends in medication non-adherence emerged among beneficiaries. Non-adherence was higher in older adults aged 65- to 74-year-olds and those with more chronic conditions (OR = 2.24; 95% CI = 1.74–2.89). If patients were dissatisfied with the medications on the insurance formulary or struggled to find a pharmacy that accepted their medication coverage, they had worse adherence (OR = 2.63; 95% CI = 1.80–3.84). Formulary and coverage must be expanded to improve adherence to antihypertensive medications in Medicare beneficiaries. Older adults aged 65 to 74 years may be less adherent to their medications because they do not see the seriousness of the disease and could benefit from further counseling. Patients with limited activities of daily living and more comorbidities may struggle with complex treatment regimens and should use adherence assistance tools.

Publisher

MDPI AG

Reference30 articles.

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2. (2023, December 28). Centers for Medicare & Medicaid Services Medicare Current Beneficiary Survey, Available online: https://www.cms.gov/Research-Statistics-Data-and-Systems/Files-for-Order/LimitedDataSets/MCBS.

3. (2023, January 20). Centers for Medicaid and Medicare Services Office of Minority Health, Hypertension Disparities in Medicare Fee-For-Service Beneficiaries, Available online: https://www.cms.gov/Files/document/data-snapshot-hypertension-jan-2023.pdf.

4. (2020, June 20). Centers for Medicaid and Medicare Services Office of Minority Health, Hypertension Disparities in Medicare Fee-For-Service Beneficiaries, Available online: https://www.cms.gov/about-cms/agency-information/omh/downloads/omh_dwnld-datasnapshot-hypertension.pdf.

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