Evidence map›Paper›PMID 22005941›Full record

Trial reportJournal of general internal medicine2012

The effects of financial pressures on adherence and glucose control among racial/ethnically diverse patients with diabetes.

Quyen Ngo-Metzger, Dara H Sorkin, John Billimek, Sheldon Greenfield, Sherrie H Kaplan

Abstract readRandomized Controlled Trial
PubMed Full text at PMC Publisher
In one paragraph

Trial report in Journal of general internal medicine, 2012. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 53 papers, 3 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
53citing papers in PubMed, 3 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

53 citing papers in PubMed, 3 syntheses or guidelines pooled it.

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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

5 authors.

Quyen Ngo-MetzgerDivision of General Internal Medicine and Primary Care and Health Policy Research Institute, University of California-Irvine, CA, USA. Qngo-metzger@hrsa.gov
Dara H Sorkin
John Billimek
Sheldon Greenfield
Sherrie H Kaplan

Funding

Reducing Diabetes Disparities Using Community CoachesR18DK069846 · NIDDK · UNIVERSITY OF CALIFORNIA-IRVINE · PI GREENFIELD, SHELDON · 2007 to 2011
$2.6M
Using Social Ties To Reduce Disparities: The Coached Care For Diabetes ProgramK01DK078939 · NIDDK · UNIVERSITY OF CALIFORNIA-IRVINE · PI SORKIN, DARA H. · 2008 to 2011
$578k
NIDDK NIH HHS K01 DK078939NIDDK NIH HHS K01DK078939NIDDK NIH HHS R18 DK069846NIDDK NIH HHS R18DK69846
6 · The paper itself

Abstract

backgroundThe Affordable Care Act is designed to decrease the numbers of uninsured patients in U.S. However, even with insurance, patients who have financial hardships may have difficulty obtaining their medications because of cost issues.

objectiveAmong patients with type 2 diabetes, to examine the association between patients' self-reported financial pressures on cost-related medication non-adherence and glucose control. Additionally, to examine whether having insurance decrease the financial pressures of diabetes care. DESIGN AND

participantsRacially/ethnically diverse patients (N = 1,361; 249 non-Hispanic whites, 194 Vietnamese, and 533 Mexican American) with type 2 diabetes were recruited from seven outpatient clinics for a cross-sectional, observational study. KEY

resultsAlthough both Vietnamese and Mexican-American patients reported having low annual incomes, more Mexican Americans reported the presence of financial barriers to getting medical care and perceived financial burden due to their diabetes, compared to whites and Vietnamese (p < 0.001). Over half (53.2%) of Mexican Americans reported cost-related non-adherence compared to 27.2% of white and 27.6% of Vietnamese patients (p < 0.001). Perceived financial burden was found to be associated with poor glucose control (HbA1c ≥8%), after adjusting for sociodemographic and health characteristics (aOR = 1.70, 95%CI 1.09-2.63), but not when adjusting for non-adherence. Similarly, a significant association between presence of financial barriers and HbA1c (aOR = 1.69, 95%CI 1.23-2.32) was attenuated with the inclusion of insurance status in the model. Being uninsured (aOR = 1.90, 95%CI 1.13-3.21) and non-adherent (aOR = 1.49, 95%CI 1.06-2.08) were each independently associated with HbA1c.

conclusionsWhile having health insurance coverage eliminated some of the financial barriers associated with having diabetes, low-income patients still faced significant financial burdens. Thus, providing health insurance to more individuals is only the first step towards eliminating health disparities. It is important to address medication cost in order to improve medication adherence and glucose control.

Indexed as

Cultural DiversityDrug MonitoringEthnicityRacial GroupsAgedConfidence IntervalsCross-Sectional StudiesDiabetes Mellitus, Type 2FemaleGlycated HemoglobinHealth Care CostsHumansLogistic ModelsMaleMedication AdherenceMiddle AgedGlycated Hemoglobin

Identifiers

PMID22005941
PMCPMC3304038

What OpenQuestion holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.