Abstract P115: Cost-related Medication Non-adherence Among Non-elderly Hypertensive Adults In The United States.

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Background: In the US, approximately 20% of prescriptions are never filled, and 50% of filled prescriptions are non-compliant with provider’s recommendations. The affordability of prescribed medicines could be a barrier for hypertensive patients leading to cost-related medication non-adherence (CRN). Methods: We used the National Health Interview Survey 2019 adult dataset to study predictors of CRN among non-elderly hypertensive adults aged 18-64. We defined CRN dichotomously based on four yes or no questions: delayed, skipped, took less medicine, and didn’t get medicine due to cost or to save money. We report descriptive statistics for the entire sample (n=5695) and a multivariable logistic regression model for the lower-income sub-sample with ≤138 federal poverty levels (FPL) (n=845). Results: Around 16% of respondents reported CRN. Females experienced CRN at a higher proportion (19.9%) than men (12.7%). Those uninsured, below 200% of the FPL, with less than a high school education, unemployed last week, had additional co-morbidities, and identified as non-Hispanic Black, more commonly experienced CRN compared to their counterparts. The subgroup analysis among lower-income (≤138 FPL) revealed an even higher rate of CRN (25.1%). Gender-based differences still existed in this sub-group, with higher CRN among women (27.6%) than men (22.5%). However, in the regression model with gender, insurance, age, education, race, co-morbidity, rural/urban geography, and having a usual source of care as covariates, only co-morbidities and insurance status had statistically significant associations. Those with one additional co-morbidity had 1.98 times the odds, and those with four or more additional co-morbidities had 3.88 times the odds of CRN compared to those with hypertension only. Medicaid enrollees had significantly lower odds of reporting CRN (OR = 0.28, p-value <0.001) than those uninsured. Conclusion: Our study provides evidence of an overall high prevalence (16%) of cost-related medication adherence in non-elderly hypertensive Americans and an even higher rate (25%) among those with lower income. As non-adherence to medication could lead to poor hypertension control, removing financial barriers to access medicines is imperative.

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