Journal of General Internal Medicine

, Volume 22, Issue 11, pp 1572–1578

Race/Ethnicity and Nonadherence to Prescription Medications Among Seniors: Results of a National Study

  • Walid F. Gellad
  • Jennifer S. Haas
  • Dana Gelb Safran
Original Article

DOI: 10.1007/s11606-007-0385-z

Cite this article as:
Gellad, W.F., Haas, J.S. & Safran, D.G. J GEN INTERN MED (2007) 22: 1572. doi:10.1007/s11606-007-0385-z

Abstract

BACKGROUND

Nonadherence to prescription drugs results in poorer control of chronic health conditions. Because of significant racial/ethnic disparities in the control of many chronic diseases, differences in the rates of and reasons for medication nonadherence should be studied.

OBJECTIVES

1) To determine whether rates of and reasons for medication nonadherence vary by race/ethnicity among seniors; and 2) to evaluate whether any association between race/ethnicity and nonadherence is moderated by prescription coverage and income.

DESIGN/SETTING

Cross-sectional national survey, 2003.

PATIENTS

Medicare beneficiaries ≥65 years of age, who reported their race/ethnicity as white, black, or Hispanic, and who reported taking at least 1 medication (n = 14,829).

MAIN OUTCOME MEASURES

Self-reported nonadherence (caused by cost, self-assessed need, or experiences/side effects) during the last 12 months.

RESULTS

Blacks and Hispanics were more likely than whites to report cost-related nonadherence (35.1%, 36.5%, and 26.7%, respectively, p < .001). There were no racial/ethnic differences in nonadherence caused by experiences or self-assessed need. In analyses controlling for age, gender, number of chronic conditions and medications, education, and presence and type of prescription drug coverage, blacks (odds ratio [OR] 1.38; 95% confidence interval [CI] 1.08–1.78) and Hispanics (1.35; 1.02–1.78) remained more likely to report cost-related nonadherence compared to whites. When income was added to the model, the relationship between cost-related nonadherence and race/ethnicity was no longer statistically significant (p = .12).

CONCLUSIONS

Racial/ethnic disparities in medication nonadherence exist among seniors, and are related to cost concerns, and not to differences in experiences or self-assessed need. Considering the importance of medication adherence in controlling chronic diseases, affordability of prescriptions should be explicitly addressed to reduce racial/ethnic disparities.

KEY WORDS

medication adherence drug therapy/economics health disparities 

Copyright information

© Society of General Internal Medicine 2007

Authors and Affiliations

  • Walid F. Gellad
    • 1
  • Jennifer S. Haas
    • 1
    • 3
  • Dana Gelb Safran
    • 2
  1. 1.Division of General Medicine and Primary Care, Department of MedicineBrigham and Women’s Hospital and Harvard Medical SchoolBostonUSA
  2. 2.The Health Institute, Tufts-New England Medical Center and Department of MedicineTufts University School of MedicineBostonUSA
  3. 3.Division of General Medicine and Primary CareBrigham andWomen’s HospitalBostonUSA

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