Antihypertensive and statin medication adherence among Medicare Beneficiaries

Details

• Alternative Title:
  Am J Prev Med
• Personal Author:
  Jackson, Sandra L. ; Nair, Priya R. ; Chang, Anping ; Schieb, Linda ; Loustalot, Fleetwood ; Wall, Hilary ; Sperling, Laurence S. ; Ritchey, Matthew D.
• Description:
  Introduction
  
  Medication adherence is important for optimal management of chronic conditions, including hypertension and hypercholesterolemia. This study describes adherence to antihypertensive and statin medications, individually and collectively, and examines variation in adherence by demographic and geographic characteristics.
  
  Methods
  
  2017 prescription drug event data for beneficiaries with Medicare Part D coverage were assessed. Beneficiaries with a proportion of days covered ≥80% were considered adherent. Adjusted prevalence ratios were estimated to quantify associations between demographic and geographic characteristics and adherence. Adherence estimates were mapped by county of residence using a spatial empirical Bayesian smoothing technique to enhance stability. Analyses were conducted 2019–2021.
  
  Results
  
  Among the 22.5 million beneficiaries prescribed antihypertensive medications, 77.1% were adherent; among the 16.1 million prescribed statin medications, 81.9% were adherent; and, among the 13.5 million prescribed antihypertensive and statin medications, 70.3% were adherent to both. Adherence varied by race/ethnicity: American Indian/Alaska Native (adjusted prevalence ratio 0.83, 95% confidence limit 0.82–0.842, Hispanic (0.90, 0.90–0.91) and non-Hispanic Black beneficiaries (0.87, 0.86–0.87) were less likely to be adherent compared to non-Hispanic White beneficiaries. County-level adherence ranged across the United States from 25.7% to 88.5% for antihypertensive medications, 36.0% to 93.8% for statin medications, and 20.8% to 92.9% for both medications combined, and tended to be the lowest in the southern United States.
  
  Conclusions
  
  This study highlights opportunities for efforts to remove barriers and support medication adherence, especially among racial/ethnic minority groups and within the regions at greatest risk for adverse cardiovascular outcomes.
  
  
• Keywords:
  Aged Antihypertensive Antihypertensive Agents Bayes Theorem Ethnicity Humans Hydroxymethylglutaryl-CoA Reductase Inhibitors Hypercholesterolemia Hypertension Medicare Part D Medication Adherence Minority Groups United States

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• Source:
  Am J Prev Med. 63(3):313-323
• Pubmed ID:
  35987557
• Pubmed Central ID:
  PMC10851130
• Document Type:
  Journal Article
• Funding:
  CC999999/ImCDC/Intramural CDC HHSUnited States/
• Volume:
  63
• Issue:
  3
• Collection(s):
  CDC Public Access
• Main Document Checksum:
  urn:sha256:d3359c1bf5d7a7e1a094b6475bce0991cf52e7c0c0acf306d0425f567c55f4ca
• Download URL:
  https://stacks.cdc.gov/view/cdc/148994/cdc_148994_DS1.pdf
• File Type:
  [PDF - 691.34 KB ]