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World J Diabetes. 2014 Dec 15;5(6):945-50. doi: 10.4239/wjd.v5.i6.945.

Risk factors for cost-related medication non-adherence among older patients with diabetes.

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James X Zhang, Jhee U Lee, David O Meltzer, Section of Hospital Medicine, Department of Medicine, the University of Chicago, Chicago, IL 60637, United States.



To assess the risk factors for cost-related medication non-adherence (CRN) among older patients with diabetes in the United States.


We used data from the 2010 Health and Retirement Study to assess risk factors for CRN including age, drug insurance coverage, nursing home residence, functional limitations, and frequency of hospitalization. CRN was self-reported. We conducted multivariate regression analysis to assess the effect of each risk factor.


Eight hundred and seventy-five (18%) of 4880 diabetes patients reported CRN. Age less than 65 years, lack of drug insurance coverage, and frequent hospitalization significantly increased risk for CRN. Limitation in both activities of daily living and instrumental activities of daily living were also generally associated with increased risk of CRN. Residence in a nursing home and Medicaid coverage significantly reduced risk.


These results suggest that expanding prescription coverage to uninsured, sicker, and community-dwelling individuals is likely to produce the largest decreases in CRN.


Cost; Medication; Non-adherence; Risk factors

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