Ethnic disparities in adherence to antihypertensive medications of medicare part D beneficiaries

Holly M. Holmes, Ruili Luo, Joseph T. Hanlon, Linda S. Elting, Maria Suarez-Almazor, James Goodwin

Research output: Contribution to journalArticle

38 Citations (Scopus)

Abstract

Objectives To determine the level of adherence to medications and characteristics of Part D beneficiaries associated with higher levels of antihypertensive medication adherence. Design Retrospective cohort study. Setting Medicare claims and Part D event files. Participants Medicare Part D enrollees with prevalent uncomplicated hypertension who filled at least one antihypertensive prescription in 2006 and two prescriptions in 2007. Measurements Medication adherence was defined as an average medication possession ratio of 80% or greater. Potential factors associated with adherence evaluated were age, sex, race or ethnicity, socioeconomic factors, comorbidity, medication use, copayments, being in the coverage gap, and number of unique prescribers. Results Overall adherence was 79.5% of 168,522 Medicare Part D enrollees with prevalent uncomplicated hypertension receiving antihypertensive medicines in 2007. In univariate analysis, adherence varied significantly according to most patient factors. In multivariable analysis, lower odds of adherence persisted for blacks (odds ratio (OR) = 0.53, 95% confidence interval (CI) = 0.51-0.55), Hispanics (OR = 0.58, 95% CI = 0.55-0.61), and other non-white races (OR = 0.80 95% CI = 0.75-0.85) than for whites. Greater comorbidity and concurrent medication use were also associated with poorer adherence. Adherence was significantly different across several geographic regions. Conclusion A number of associations were identified between patient factors and adherence to antihypertensive drugs, with significant differences in adherence according to ethnicity. Improving adherence could have significant public health implications and could improve outcomes specific to hypertension, as well as improving cost and healthcare utilization.

Original languageEnglish (US)
Pages (from-to)1298-1303
Number of pages6
JournalJournal of the American Geriatrics Society
Volume60
Issue number7
DOIs
StatePublished - Jul 2012

Fingerprint

Medicare Part D
Antihypertensive Agents
Medication Adherence
Odds Ratio
Confidence Intervals
Hypertension
Prescriptions
Comorbidity
Patient Compliance
Hispanic Americans
Health Care Costs
Cohort Studies
Retrospective Studies
Public Health

Keywords

  • ethnic disparities
  • Medicare Part D
  • medication adherence

ASJC Scopus subject areas

  • Geriatrics and Gerontology

Cite this

Ethnic disparities in adherence to antihypertensive medications of medicare part D beneficiaries. / Holmes, Holly M.; Luo, Ruili; Hanlon, Joseph T.; Elting, Linda S.; Suarez-Almazor, Maria; Goodwin, James.

In: Journal of the American Geriatrics Society, Vol. 60, No. 7, 07.2012, p. 1298-1303.

Research output: Contribution to journalArticle

Holmes, Holly M. ; Luo, Ruili ; Hanlon, Joseph T. ; Elting, Linda S. ; Suarez-Almazor, Maria ; Goodwin, James. / Ethnic disparities in adherence to antihypertensive medications of medicare part D beneficiaries. In: Journal of the American Geriatrics Society. 2012 ; Vol. 60, No. 7. pp. 1298-1303.
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