Skip to main content
SpringerLink
Log in

Adherence to Chronic Disease Medications among New York City Medicaid Participants

  • Published:
Journal of Urban Health Aims and scope Submit manuscript

Abstract

Medication adherence is critical for cardiovascular disease prevention and control. Local health departments are well positioned to address adherence issues, however relevant baseline data and a mechanism for monitoring impact of interventions are lacking. We performed a retrospective analysis using New York State Medicaid claims from 2008 to 2009 to describe rates and predictors of adherence among New York City Medicaid participants with dyslipidemia, diabetes, or hypertension. Adherence was measured using the medication possession ratio, and multivariable logistic regression was used to assess factors related to adherence. Medication regimen adherence was 63%. Greater adherence was observed in those who were older, male, and taking medications from ≥3 drug classes. Compared with whites, blacks and Hispanics were less likely to be adherent (adjusted odds ratio [OR]=0.67, 95% confidence interval [CI]: 0.65–0.70 and adjusted OR=0.76, 95% CI: 0.73–0.78, respectively), while Asians were as likely. Medication adherence was inadequate and racial disparities were identified in NYC Medicaid participants on stable medication regimens for chronic disease. This study demonstrates a claims-based model that may be used by local health departments to monitor and evaluate efforts to improve adherence and reduce disparities.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

References

  1. Ho PM, Bryson CL, Rumsfeld JS. Medication adherence: its importance in cardiovascular outcomes. [Review] [79 refs]. Circulation. 2009; 119(23): 3028–35.

    Article  PubMed  Google Scholar 

  2. Batal HA, Krantz MJ, Dale RA, Mehler PS, Steiner JF. Impact of prescription size on statin adherence and cholesterol levels. BMC Health Svc Res. 2007; 7: 175.

    Article  Google Scholar 

  3. Steiner JF, Robbins LJ, Roth SC, Hammond WS. The effect of prescription size on acquisition of maintenance medications. J Gen Intern Med. 1993; 8(6): 306–10.

    Article  PubMed  CAS  Google Scholar 

  4. Choudhry NK, Fischer MA, Avorn J, et al. The implications of therapeutic complexity on adherence to cardiovascular medications. Arch Intern Med. 2011; 171(9): 814–22.

    Article  PubMed  Google Scholar 

  5. Cutler DM, Everett W. Thinking outside the pillbox—medication adherence as a priority for health care reform. New Engl J Med. 2010; 362(17): 1553–5.

    Article  PubMed  CAS  Google Scholar 

  6. Bluml BM, McKenney JM, Cziraky MJ. Pharmaceutical care services and results in project ImPACT: hyperlipidemia. J Am Pharm Assoc. 2000; 40(2): 157–65.

    CAS  Google Scholar 

  7. Center for Medicare and Medicaid Services. 2011 Medicare Part D Medication Therapy (MTM) Programs. Available at: http://www.cms.gov/PrescriptionDrugCovContra/Downloads/MTMFactSheet2011063011Final.pdf. Accessed 1 May 2012

  8. Steiner JF, Prochazka AV. The assessment of refill compliance using pharmacy records: methods, validity, and applications. J Clin Epidemiol. 1997; 50(1): 105–16.

    Article  PubMed  CAS  Google Scholar 

  9. Steiner JF, Koepsell TD, Fihn SD, Inui TS. A general method of compliance assessment using centralized pharmacy records. Description and validation. Med Care. 1988; 26(8): 814–23.

    Article  PubMed  CAS  Google Scholar 

  10. Schectman JM, Bovbjerg VE, Voss JD. Predictors of medication-refill adherence in an indigent rural population. Med Care. 2002; 40(12): 1294–300.

    Article  PubMed  Google Scholar 

  11. Halpern MT, Khan ZM, Schmier JK, et al. Recommendations for evaluating compliance and persistence with hypertension therapy using retrospective data. Hypertension. 2006; 47(6): 1039–48.

    Article  PubMed  CAS  Google Scholar 

  12. Chapman RH, Benner JS, Petrilla AA, et al. Predictors of adherence with antihypertensive and lipid-lowering therapy. Arch Intern Med. 2005; 165(10): 1147–52.

    Article  PubMed  Google Scholar 

  13. Osterberg L, Blaschke T. Adherence to medication. N Engl J Med. 2005; 353(5): 487–97.

    Article  PubMed  CAS  Google Scholar 

  14. Bailey JE, Wan JY, Tang J, Ghani MA, Cushman WC. Antihypertensive medication adherence, ambulatory visits, and risk of stroke and death. J Gen Intern Med. 2010; 25(6): 495–503.

    Article  PubMed  Google Scholar 

  15. Traylor AH, Schmittdiel JA, Uratsu CS, Mangione CM, Subramanian U. Adherence to cardiovascular disease medications: does patient-provider race/ethnicity and language concordance matter? J Gen Intern Med. 2010; 25(11): 1172–7.

    Article  PubMed  Google Scholar 

  16. Chan DC, Shrank WH, Cutler D, et al. Patient, physician, and payment predictors of statin adherence. Med Care. 2010; 48(3) 196–202.

    Google Scholar 

  17. Shaya FT, Du D, Gbarayor CM, Frech-Tamas F, Lau H, Weir MR. Predictors of compliance with antihypertensive therapy in a high-risk medicaid population. J Natl Med Assoc. 2009; 101(1): 34–9.

    PubMed  Google Scholar 

  18. Shenolikar RA, Balkrishnan R, Camacho FT, Whitmire JT, Anderson RT. Race and medication adherence in Medicaid enrollees with type-2 diabetes. J Natl Med Assoc. 2006; 98(7): 1071–7.

    PubMed  Google Scholar 

Download references

Acknowledgements

The authors thank Nancy Kim, MD, PhD, for her input regarding statistical issues.

Author information

Authors and Affiliations

  1. Department of Population Health, New York University School of Medicine, New York, NY, USA

    Kelly A. Kyanko

  2. New York State Department of Health, Albany, NY, USA

    Robert H. Franklin

  3. New York City Department of Health and Mental Hygiene, New York, NY, USA

    Sonia Y. Angell

  4. Centers for Disease Control and Prevention, Atlanta, GA, USA

    Sonia Y. Angell

Authors
  1. Kelly A. Kyanko
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Robert H. Franklin
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Sonia Y. Angell
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Kelly A. Kyanko.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Kyanko, K.A., Franklin, R.H. & Angell, S.Y. Adherence to Chronic Disease Medications among New York City Medicaid Participants. J Urban Health 90, 323–328 (2013). https://doi.org/10.1007/s11524-012-9724-4

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s11524-012-9724-4

Keywords

Search

Navigation