Adherence to antiepileptic drugs among diverse older Americans on Part D Medicare.
Epilepsy Behav
; 66: 68-73, 2017 01.
Article
en En
| MEDLINE
| ID: mdl-28038389
ABSTRACT
INTRODUCTION:
Older minority groups are more likely to have poor AED adherence. We describe adherence to antiepileptic drugs (AEDs) among older Americans with epilepsy.METHODS:
In retrospective analyses of 2008-2010 Medicare claims for a 5% random sample of beneficiaries augmented by minority representation, epilepsy cases in 2009 were those with ≥1 claim with ICD-9345.x or ≥2 with 780.3x, and ≥1 AED. New-onset cases had no such claims or AEDs in the year before the 2009 index event. We calculated the Proportion of Days Covered (PDC) (days with ≥1 AED over total follow-up days) and used logistic regression to estimate associations of non-adherence (PDC <0.8) with minority group adjusting for covariates.RESULTS:
Of 36,912 epilepsy cases (19.2% White, 62.5% African American (AA), 11.3% Hispanic, 5.0% Asian and 2% American Indian/Alaskan Native), 31.8% were non-adherent (range 24.1% Whites to 34.3% AAs). Of 3706 new-onset cases, 37% were non-adherent (range 28.7% Whites to 40.5% AAs). In adjusted analyses, associations with minority group were significant among prevalent cases, and for AA and Asians vs. Whites among new cases. Among other findings, beneficiaries from high-poverty ZIP codes were more likely to be non-adherent than their counterparts, and those in cost-sharing drug benefit phases were less likely to be non-adherent than those in deductible phases.CONCLUSION:
About a third of older adults with epilepsy have poor AED adherence; minorities are more likely than Whites. Investigations of reasons for non-adherence, and interventions to promote adherence, are needed with particular attention to the effect of cost-sharing and poverty.Palabras clave
Texto completo:
1
Banco de datos:
MEDLINE
Asunto principal:
Etnicidad
/
Epilepsia
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Medicare Part D
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Cumplimiento de la Medicación
/
Anticonvulsivantes
Tipo de estudio:
Etiology_studies
/
Incidence_studies
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Observational_studies
/
Risk_factors_studies
Límite:
Aged
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Aged80
/
Female
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Humans
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Male
País como asunto:
America do norte
Idioma:
En
Año:
2017
Tipo del documento:
Article