Hypertension Medication and Medicare Beneficiaries: Prescription Drug Coverage Satisfaction and Medication Non-Adherence among Older Adults
Abstract
:1. Introduction
2. Methods
2.1. Study Design
2.2. Study Participants
2.3. Measures
2.3.1. Dependent Variables
2.3.2. Independent Variables
2.3.3. Prescription Drug Insurance Coverage
2.3.4. Prescription Drug Coverage Satisfaction
2.3.5. Sociodemographic and Health-Related Covariates
2.4. Statistical Analysis
3. Results
4. Discussion
5. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
References
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Variable | Total | Medication Adherence | Medication Non-Adherence | p-Value |
---|---|---|---|---|
Unweighted n | 3917 | 3497 | 420 | |
Weighted n | 27,134,782 | 23,941,094 | 3,193,687 | |
Overall (weighted %) | 100 | 88.2 | 11.8 | |
Sociodemographic Characteristics | ||||
Age group | <0.001 | |||
65–74 years | 55.8 | 54.2 | 67.4 | |
≥75 years | 44.2 | 45.8 | 32.6 | |
Sex | 0.058 | |||
Female | 57.2 | 56.6 | 62.0 | |
Male | 42.8 | 43.4 | 38.0 | |
Race/ethnicity | 0.153 | |||
White | 75.4 | 76.0 | 70.7 | |
Black | 10.6 | 10.3 | 12.8 | |
Hispanic | 7.6 | 7.7 | 6.8 | |
Other | 6.5 | 6.0 | 9.6 | |
Marital status | 0.731 | |||
Married | 54.6 | 54.9 | 52.6 | |
Widowed | 23.5 | 23.5 | 23.8 | |
Divorced/separated | 15.9 | 15.8 | 16.3 | |
Never married | 6.0 | 5.8 | 7.3 | |
Education | 0.267 | |||
Less than HS | 11.9 | 11.7 | 13.1 | |
HS or vocational | 30.0 | 29.6 | 32.7 | |
More than HS | 58.1 | 58.6 | 54.1 | |
Income | <0.001 | |||
<USD 25,000 | 26.8 | 25.2 | 34.4 | |
≥USD 25,000 | 73.2 | 74.8 | 65.6 | |
Residing area | 0.181 | |||
Non-metro area | 16.6 | 16.3 | 19.1 | |
Metro | 83.4 | 83.7 | 80.9 | |
Comorbidities and Health Status | ||||
Number of chronic conditions | <0.001 | |||
0–1 | 30.5 | 32.5 | 15.3 | |
2–3 | 50.1 | 50.2 | 50.0 | |
≥4 | 19.4 | 17.4 | 34.7 | |
ADL limitations | <0.001 | |||
No limitations | 63.7 | 66.3 | 43.9 | |
Only IADLs limited | 12.6 | 11.6 | 19.9 | |
1–2 ADLs limited | 17.4 | 16.3 | 25.4 | |
≥3 ADLs limited | 6.3 | 5.7 | 10.8 | |
General health status | <0.001 | |||
Excellent/very good | 50.5 | 52.8 | 33.9 | |
Good | 31.7 | 30.9 | 37.8 | |
Fair/poor | 17.8 | 16.4 | 28.4 | |
Drug Coverage Plan | ||||
Medicare Advantage plan coverage | 0.443 | |||
No | 55.5 | 55.8 | 52.8 | |
Yes | 44.5 | 44.2 | 47.2 | |
Private plan coverage | 0.003 | |||
No | 75.2 | 74.2 | 82.6 | |
Yes | 24.8 | 25.8 | 17.4 | |
Part D plan coverage | <0.001 | |||
No | 17.6 | 18.6 | 10.8 | |
Yes | 82.4 | 81.4 | 89.2 | |
Prescription Drug Insurance Satisfaction | ||||
Dissatisfaction: the amount paid for medications | <0.001 | |||
No | 90.0 | 92.6 | 70.9 | |
Yes | 10.0 | 7.4 | 29.1 | |
Dissatisfaction: the medications on the formulary | <0.001 | |||
No | 95.0 | 96.5 | 83.0 | |
Yes | 5.1 | 3.5 | 17.0 | |
Dissatisfaction: find a pharmacy that accepted medication coverage | 0.039 | |||
No | 98.9 | 99.1 | 97.0 | |
Yes | 1.1 | 0.9 | 3.0 |
Variable | OR * | 95% CI † | p-Value |
---|---|---|---|
Sociodemographic Characteristics | |||
Age group | |||
65–74 years | 2.24 | 1.74–2.89 | <0.001 |
≥75 years | Ref ‡ | ||
Sex | |||
Female | Ref | ||
Male | 0.94 | 0.72–1.24 | 0.663 |
Race/ethnicity | |||
White | Ref | ||
Black | 1.04 | 0.65–1.67 | 0.869 |
Hispanic | 0.74 | 0.42–1.33 | 0.310 |
Other | 1.81 | 1.08–3.02 | 0.025 |
Marital status | |||
Married | Ref | ||
Widowed | 1.02 | 0.73–1.41 | 0.926 |
Divorced/separated | 0.86 | 0.59–1.25 | 0.411 |
Never married | 1.18 | 0.72–1.92 | 0.514 |
Education | |||
Less than HS | 0.75 | 0.47–1.20 | 0.233 |
HS or vocational | Ref | ||
More than HS | 0.92 | 0.72–1.19 | 0.537 |
Income | |||
<USD 25,000 | 1.38 | 0.97–1.98 | 0.077 |
≥USD 25,000 | Ref | ||
Residing area | |||
Non-metro area | Ref | ||
Metro | 1.08 | 0.83–1.40 | 0.578 |
Comorbidities and Health Status | |||
Number of chronic conditions | |||
0–1 | Ref | ||
2–3 | 1.81 | 1.37–2.39 | <0.001 |
≥4 | 2.81 | 1.82–4.35 | <0.001 |
ADL limitations | |||
No limitations | Ref | ||
Only IADLs limited | 1.85 | 1.34–2.57 | <0.001 |
1–2 ADLs limited | 1.62 | 1.13–2.31 | 0.010 |
≥3 ADLs limited | 1.84 | 1.16–2.92 | 0.010 |
General health status | |||
Excellent/very good | 0.69 | 0.51–0.95 | 0.023 |
Good | Ref | ||
Fair/poor | 0.81 | 0.54–1.21 | 0.294 |
Drug Coverage | |||
Medicare advantage plan coverage | |||
No | Ref | ||
Yes | 1.06 | 0.78–1.44 | 0.716 |
Private plan coverage | |||
No | Ref | ||
Yes | 0.75 | 0.53–1.08 | 0.126 |
Part D plan coverage | |||
No | Ref | ||
Yes | 1.32 | 0.81–2.15 | 0.255 |
Prescription Drug Insurance Satisfaction | |||
Dissatisfaction: the amount paid for medications | |||
No | Ref | ||
Yes | 3.39 | 2.43–4.72 | <0.001 |
Dissatisfaction: the medications on the formulary | |||
No | Ref | ||
Yes | 2.63 | 1.80–3.84 | <0.001 |
Dissatisfaction: find a pharmacy that accepted medication coverage | |||
No | Ref | ||
Yes | 2.01 | 0.84–4.77 | 0.114 |
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Park, J.-H.; Kim, K.; Medina, M.; Ng, B.P.; Smith, M.L.; Edafetanure-Ibeh, O.M.; Chang, J. Hypertension Medication and Medicare Beneficiaries: Prescription Drug Coverage Satisfaction and Medication Non-Adherence among Older Adults. Healthcare 2024, 12, 722. https://doi.org/10.3390/healthcare12070722
Park J-H, Kim K, Medina M, Ng BP, Smith ML, Edafetanure-Ibeh OM, Chang J. Hypertension Medication and Medicare Beneficiaries: Prescription Drug Coverage Satisfaction and Medication Non-Adherence among Older Adults. Healthcare. 2024; 12(7):722. https://doi.org/10.3390/healthcare12070722
Chicago/Turabian StylePark, Jeong-Hui, Kiyoung Kim, Mar Medina, Boon Peng Ng, Matthew Lee Smith, Okeoghene Marcel Edafetanure-Ibeh, and Jongwha Chang. 2024. "Hypertension Medication and Medicare Beneficiaries: Prescription Drug Coverage Satisfaction and Medication Non-Adherence among Older Adults" Healthcare 12, no. 7: 722. https://doi.org/10.3390/healthcare12070722
APA StylePark, J.-H., Kim, K., Medina, M., Ng, B. P., Smith, M. L., Edafetanure-Ibeh, O. M., & Chang, J. (2024). Hypertension Medication and Medicare Beneficiaries: Prescription Drug Coverage Satisfaction and Medication Non-Adherence among Older Adults. Healthcare, 12(7), 722. https://doi.org/10.3390/healthcare12070722