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Study: CVS Caremark researchers explore demographic factors on medication adherence

WOONSOCKET, R.I. — A study conducted by researchers at CVS Caremark and Brigham and Women's Hospital and published in the May issue of the American Heart Journal found that non-white patients had 50% greater odds of statin medication nonadherence compared with white patients, while women had 10% greater odds of statin nonadherence compared with men.

The researchers noted that there are a number of potential reasons for nonadherence among women and non-white patients. For example, active prevention of cardiovascular disease may not be a priority for women and their healthcare providers because of the common misconception that women are less at risk than men. In addition, women also frequently serve as informal caregivers for family members and may be further impacted by the fact that caregivers frequently have lower rates of medication adherence.   

The reasons that non-white patients may be nonadherent may be more complex. As an example, the researchers noted that non-white patients are less likely to have a consistent relationship with a primary care provider than white patients which can impact chronic care and adherence. Additionally, both women and various racial and ethnic minorities may be more likely to experience side effects from statins, a commonly cited reason for early discontinuation or poor adherence. 

"These findings help us better understand the impact of certain demographic factors on medication adherence," stated Niteesh Choudhry, associate physician, Division of Pharmacoepidemiology and Pharmacoeconomics, Brigham and Women's Hospital and associate professor, Harvard Medical School. "Since a large number of patients depend on medication therapy for primary and secondary prevention of cardiovascular disease, we believe that efforts to reduce nonadherence for statins can have a significant effect on addressing health care disparities, improving health outcomes and ultimately reducing costs."

The study consisted of a literature review of more than 50 publications focused on gender and racial disparities associated with medication adherence and included more than 1.7 million patients. Of note, the finding that nonadherence was higher based on the patient's gender or race held true even in those studies that adjusted for income, insurance status, co-payment amounts and other clinically important factors that could contribute to nonadherence.

"While it has long been known that sociodemographic characteristics are associated with nonadherence, this study is the first of its kind to look at the scale and scope of this association," commented Troy Brennan, EVP and chief medical officer of CVS Caremark. "This research helps those of us in the healthcare field better understand how to improve our outreach to patients who may be at a higher risk of non-adherence and develop programs to help these patients improve their medication adherence."

CVS Caremark has been working in a multi-year collaboration with Brigham and Women's Hospital to research pharmacy claims data in order to better understand patient behavior, particularly around medication adherence. Annual excess healthcare costs due to medication nonadherence in the U.S. have been estimated to be as much as $290 billion annually.

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Non-adherence affects

Non-adherence affects everyone, however, as shown by this study and others, it seems to apply more to certain groups over others. Medication non-adherence is largely a psychological issue, due to negative associations with medication and a lack of motivation. While this study found that non-whites and women had higher non-adherence, HealthPrize recently conducted a survey and found adults aged 18-34 struggled the most with adherence. 60% of this group admitted to not taking their medication as prescribed over the past year, which was double the rate of adults 65 years old and older.To find out why, read more here: http://bit.ly/194OyYo. -Dr. Katrina Firlik
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