ArticlePatient preference and adherence2017
Out-of-pocket costs and adherence to antihypertensive agents among older adults covered by the public drug insurance plan in Quebec.
Article in Patient preference and adherence, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers, 1 of them a synthesis that pooled it.
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Who cites it
7 citing papers in PubMed, 1 synthesis or guideline pooled it.
- The economic burden of treating uncomplicated hypertension in Sub-Saharan Africa: a systematic literature review.BMC public health · 2022Pooled it
- Assessment of the utilization of real-time prescription benefits for patient cost savings within an outpatient setting.Exploratory research in clinical and social pharmacy · 2024Article
- Knowledge, attitude, behaviour, and influencing factors of home-based medication safety among community-dwelling older adults with chronic diseases: a cross-sectional study.BMC geriatrics · 2023Article
- Association Between Cost-Saving Prescription Policy Changes and Adherence to Chronic Disease Medications: an Observational Study.Journal of general internal medicine · 2022Observational
- Out-of-pocket expenditure for hypertension care: a population-based study in low-income urban Medellin, Colombia.Global health action · 2020Article
- A global perspective on the costs of hypertension: a systematic review.Archives of medical science : AMS · 2020Review
- We need to mandate drug cost transparency on electronic medical records.CMAJ : Canadian Medical Association journal = journal de l'Association medicale canadienne · 2017Article
Corrections and comments
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Authors and funding
4 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectiveTo evaluate the effect of patient out-of-pocket costs on adherence to antihypertensive agents (AHA) in community-dwelling older adults covered by the public drug insurance plan in Quebec.
methodsThis is a secondary analysis of data from the "Étude sur la santé des aînés" study (2005-2008) on community-dwelling older adults in Quebec aged 65 years and older (N=2,811). The final sample included 881 participants diagnosed with arterial hypertension and treated with AHA. Medication adherence was measured with the proportion of days covered over a 2-year follow-up period (<80% and ≥80%). Out-of-pocket costs for AHA, in Canadian dollars (CAD), at cohort entry were categorized as follows: $0, $0.01-$5.00, $5.01-$10.00, $10.01-$15.00 and $15.01-$36.00. Multivariable logistic regression models were constructed to study adherence to AHA as a function of out-of-pocket costs while controlling for several confounders. Models were also stratified by annual household income (<$15,000 CAD and ≥$15,000 CAD).
resultsIn this study, 80.8% of participants were adherent to their AHA. Among participants reporting an annual household income <$15,000 CAD, those with an out-of-pocket cost of $10.01-$15.00 CAD were significantly less adherent to their AHA than those with no contribution (OR =0.175, 95% CI: 0.042-0.740). Among participants reporting an income of ≥$15,000 CAD, those with out-of-pocket costs of $0.01-$5.00 CAD (OR =0.194; 95% CI: 0.048-0.787), $5.01-$10.00 CAD (OR =0.146; 95% CI: 0.036-0.589), $10.01-$15.00 CAD (OR =0.192; 95% CI: 0.047-0.777) and $15.01-$36.00 CAD (OR =0.160, 95% CI: 0.039-0.655) were significantly less adherent to their AHA than participants with no contribution.
conclusionIncreased out-of-pocket costs are associated with non-adherence to AHA in older adults covered by a public drug insurance plan, more importantly in those reporting an annual household income ≥$15,000 CAD. A reduction in the amount of out-of-pocket costs and yearly maximum contribution for drugs may improve adherence to treatment.
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