Evidence map›Paper›PMID 32075894›Full record

ArticleNeurology2020

Association of out-of-pocket costs on adherence to common neurologic medications.

Evan L Reynolds, James F Burke, Mousumi Banerjee, Kevin A Kerber, Lesli E Skolarus, Brandon Magliocco, Gregory J Esper, Brian C Callaghan

Open access · bronzeAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Neurology, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 13 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
13citing papers in PubMed, 2 pooled it
2.9field-weighted citation impact, top 10% of its field
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

13 citing papers in PubMed, 2 syntheses or guidelines pooled it, 25 citations in OpenAlex.

  1. Pooled it
  2. Pooled it
  3. Article
  4. Article
  5. Review
  6. Article
  7. Review
  8. Article
  9. Article
  10. Cost and utilization of healthcare services for persons with diabetes.Diabetes research and clinical practice · 2023
    Article
  11. Article
  12. Article
  13. Article
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

8 authors at 1 institution in 1 country.

Evan L ReynoldsFrom the Health Services Research Program, Department of Neurology (E.L.R., J.F.B., K.A.K., L.E.S., B.C.C.), and School of Public Health (M.B.), University of Michigan; Veterans Affairs Healthcare System (J.F.B., B.C.C.), Ann Arbor, MI; American Academy of Neurology (B.M.), Minneapolis, MN; and the Department of Neurology (G.J.E.), Emory University, Atlanta, GA.ORCID 0000-0002-0138-8436
James F BurkeFrom the Health Services Research Program, Department of Neurology (E.L.R., J.F.B., K.A.K., L.E.S., B.C.C.), and School of Public Health (M.B.), University of Michigan; Veterans Affairs Healthcare System (J.F.B., B.C.C.), Ann Arbor, MI; American Academy of Neurology (B.M.), Minneapolis, MN; and the Department of Neurology (G.J.E.), Emory University, Atlanta, GA.
Mousumi BanerjeeFrom the Health Services Research Program, Department of Neurology (E.L.R., J.F.B., K.A.K., L.E.S., B.C.C.), and School of Public Health (M.B.), University of Michigan; Veterans Affairs Healthcare System (J.F.B., B.C.C.), Ann Arbor, MI; American Academy of Neurology (B.M.), Minneapolis, MN; and the Department of Neurology (G.J.E.), Emory University, Atlanta, GA.
Kevin A KerberFrom the Health Services Research Program, Department of Neurology (E.L.R., J.F.B., K.A.K., L.E.S., B.C.C.), and School of Public Health (M.B.), University of Michigan; Veterans Affairs Healthcare System (J.F.B., B.C.C.), Ann Arbor, MI; American Academy of Neurology (B.M.), Minneapolis, MN; and the Department of Neurology (G.J.E.), Emory University, Atlanta, GA.
Lesli E SkolarusFrom the Health Services Research Program, Department of Neurology (E.L.R., J.F.B., K.A.K., L.E.S., B.C.C.), and School of Public Health (M.B.), University of Michigan; Veterans Affairs Healthcare System (J.F.B., B.C.C.), Ann Arbor, MI; American Academy of Neurology (B.M.), Minneapolis, MN; and the Department of Neurology (G.J.E.), Emory University, Atlanta, GA.
Brandon MaglioccoFrom the Health Services Research Program, Department of Neurology (E.L.R., J.F.B., K.A.K., L.E.S., B.C.C.), and School of Public Health (M.B.), University of Michigan; Veterans Affairs Healthcare System (J.F.B., B.C.C.), Ann Arbor, MI; American Academy of Neurology (B.M.), Minneapolis, MN; and the Department of Neurology (G.J.E.), Emory University, Atlanta, GA.
Gregory J EsperFrom the Health Services Research Program, Department of Neurology (E.L.R., J.F.B., K.A.K., L.E.S., B.C.C.), and School of Public Health (M.B.), University of Michigan; Veterans Affairs Healthcare System (J.F.B., B.C.C.), Ann Arbor, MI; American Academy of Neurology (B.M.), Minneapolis, MN; and the Department of Neurology (G.J.E.), Emory University, Atlanta, GA.
Brian C CallaghanFrom the Health Services Research Program, Department of Neurology (E.L.R., J.F.B., K.A.K., L.E.S., B.C.C.), and School of Public Health (M.B.), University of Michigan; Veterans Affairs Healthcare System (J.F.B., B.C.C.), Ann Arbor, MI; American Academy of Neurology (B.M.), Minneapolis, MN; and the Department of Neurology (G.J.E.), Emory University, Atlanta, GA. bcallagh@med.umich.edu.ORCID 0000-0002-8885-6748
Emory University · US

Funding

Implementation of Evidence-Based Practice for Benign Paroxysmal Positional VertigR01DC012760 · NIDCD · UNIVERSITY OF MICHIGAN AT ANN ARBOR · PI KERBER, KEVIN ANTHONY, MEURER, WILLIAM JOSEPH · 2013 to 2024
$6.2M
Reach Out: Randomized Clinical Trial of Emergency Department-Initiated Hypertension Behavioral Intervention Connecting Multiple Health SystemsR01MD011516 · NIMHD · UNIVERSITY OF MICHIGAN AT ANN ARBOR · PI MEURER, WILLIAM JOSEPH, SKOLARUS, LESLI ELIZABETH · 2017 to 2020
$3.3M
A Community Based Participatory Trial to Increase Stroke TreatmentU01MD010579 · NIMHD · UNIVERSITY OF MICHIGAN AT ANN ARBOR · PI BROWN, DEVIN L · 2016 to 2020
$2.8M
Reducing Racial Disparities in Post-Stroke Disability in the ElderlyR01MD008879 · NIMHD · UNIVERSITY OF MICHIGAN AT ANN ARBOR · PI BURKE, JAMES FRANCIS, SKOLARUS, LESLI ELIZABETH · 2014 to 2018
$1.9M
Solutions for Vertigo presentations in the Emergency Department (SOLVE) ProjectR18HS017690 · AHRQ · UNIVERSITY OF MICHIGAN AT ANN ARBOR · PI KERBER, KEVIN ANTHONY · 2009 to 2012
$1.5M
Self-Diagnosis and Treatment Tools for Benign Paroxysmal Positional VertigoR18HS022258 · AHRQ · UNIVERSITY OF MICHIGAN AT ANN ARBOR · PI KERBER, KEVIN ANTHONY · 2014 to 2018
$1.2M
Using Outcomes Analyses to Inform Implementation of NINDS Clinical TrialsK08NS082597 · NINDS · UNIVERSITY OF MICHIGAN AT ANN ARBOR · PI BURKE, JAMES FRANCIS · 2013 to 2017
$948k
The Impact of the Metabolic Syndrome on NeuropathyK23NS079417 · NINDS · UNIVERSITY OF MICHIGAN AT ANN ARBOR · PI CALLAGHAN, BRIAN CHRISTOPHER · 2013 to 2017
$939k
Dizziness in the Emergency Department: A Population-Based ProjectK23RR024009 · NCRR · UNIVERSITY OF MICHIGAN AT ANN ARBOR · PI KERBER, KEVIN ANTHONY · 2007 to 2011
$797k
AHRQ HHS R18 HS017690AHRQ HHS R18 HS022258CSRD VA I01 CX001504NCRR NIH HHS K23 RR024009NIDCD NIH HHS R01 DC012760NIMHD NIH HHS R01 MD008879NIMHD NIH HHS R01 MD011516NIMHD NIH HHS U01 MD010579NINDS NIH HHS K08 NS082597NINDS NIH HHS K23 NS079417
6 · The paper itself

Abstract

objectiveTo determine the association between out-of-pocket costs and medication adherence in 3 common neurologic diseases.

methodsUtilizing privately insured claims from 2001 to 2016, we identified patients with incident neuropathy, dementia, or Parkinson disease (PD). We selected patients who were prescribed medications with similar efficacy and tolerability, but differential out-of-pocket costs (neuropathy with gabapentinoids or mixed serotonin/norepinephrine reuptake inhibitors [SNRIs], dementia with cholinesterase inhibitors, PD with dopamine agonists). Medication adherence was defined as the number of days supplied in the first 6 months. Instrumental variable analysis was used to estimate the association of out-of-pocket costs and other patient factors on medication adherence.

resultsWe identified 52,249 patients with neuropathy on gabapentinoids, 5,246 patients with neuropathy on SNRIs, 19,820 patients with dementia on cholinesterase inhibitors, and 3,130 patients with PD on dopamine agonists. Increasing out-of-pocket costs by $50 was associated with significantly lower medication adherence for patients with neuropathy on gabapentinoids (adjusted incidence rate ratio [IRR] 0.91, 0.89-0.93) and dementia (adjusted IRR 0.88, 0.86-0.91). Increased out-of-pocket costs for patients with neuropathy on SNRIs (adjusted IRR 0.97, 0.88-1.08) and patients with PD (adjusted IRR 0.90, 0.81-1.00) were not significantly associated with medication adherence. Minority populations had lower adherence with gabapentinoids and cholinesterase inhibitors compared to white patients.

conclusionsHigher out-of-pocket costs were associated with lower medication adherence in 3 common neurologic conditions. When prescribing medications, physicians should consider these costs in order to increase adherence, especially as out-of-pocket costs continue to rise. Racial/ethnic disparities were also observed; therefore, minority populations should receive additional focus in future intervention efforts to improve adherence.

Indexed as

Health ExpendituresMedication AdherenceAdultAgedAntiparkinson AgentsCholinesterase InhibitorsDementiaExcitatory Amino Acid AntagonistsFemaleGabapentinHumansMaleMiddle AgedParkinson DiseasePeripheral Nervous System DiseasesSelective Serotonin Reuptake InhibitorsAntiparkinson AgentsCholinesterase InhibitorsExcitatory Amino Acid AntagonistsGabapentinSelective Serotonin Reuptake Inhibitors

Identifiers

PMID32075894
PMCPMC7274913
OpenAlexW3008147607

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

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.