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Cost-related Medication Nonadherence among Medicare Beneficiaries with Cardiovascular Disease Risk Factors: The Role of Comprehension of the Medicare Program and its Prescription Drug Benefits
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  • Chanhyun Park,
  • Angela Chang,
  • Boon Ng,
  • Gary Young
Chanhyun Park
Northeastern University
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Angela Chang
Northeastern University
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Boon Ng
University of Central Florida
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Gary Young
Northeastern University
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Abstract

RATIONALE, AIMS, AND OBJECTIVES: This study aims to investigate how reported comprehension of the Medicare program and its prescription drug benefits affects cost-related medication nonadherence (CRN) among Medicare beneficiaries with cardiovascular disease (CVD) risk factors. METHODS: This cross-sectional study used the 2017 Medicare Current Beneficiary Survey Public Use File data and included Medicare beneficiaries aged ≥ 65 years who reported having at least one CVD risk factor (i.e., hypertension, hyperlipidemia, diabetes, smoking, and obesity) (n=2,821). A survey-weighted logistic model was used to examine associations between lack of difficulty understanding the Medicare program and its prescription drug benefits and CRN, controlling for beneficiaries’ demographic (e.g., age) and clinical characteristics (e.g, comorbidities). This study further analyzed five subgroups based on the type of CVD risk factors involved. RESULTS: Among Medicare beneficiaries with CVD risk factors, 14.4% reported CRN. Medicare beneficiaries with CVD risk factors who reported difficulty understanding the overall Medicare program and its prescription drug benefits were more likely to report CRN, compared to those who reported easy understanding of the overall Medicare program (OR=1.49; 95% CI=1.09, 2.04; p<0.001) and its prescription drug benefits (OR=2.01; 95% CI=1.51, 2.67; p<0.001). Similar results were obtained for the subgroups with obesity, hypertension, or hyperlipidemia. CONCLUSIONS: Perceived lack of difficulty understanding the Medicare Program and its prescription drug benefits has a positive impact on CRN reduction among Medicare beneficiaries with CVD risk factors, especially those with obesity, hypertension or hyperlipidemia. Monitoring and enhancing Medicare beneficiaries’ overall understanding of the Medicare program may reduce CRN.
16 Nov 2021Submitted to Journal of Evaluation in Clinical Practice
19 Nov 2021Submission Checks Completed
19 Nov 2021Assigned to Editor
24 Nov 2021Reviewer(s) Assigned
09 Mar 2022Review(s) Completed, Editorial Evaluation Pending
09 Mar 2022Editorial Decision: Revise Major
08 Jun 20221st Revision Received
15 Jun 2022Submission Checks Completed
15 Jun 2022Assigned to Editor
29 Jun 2022Review(s) Completed, Editorial Evaluation Pending
01 Jul 2022Editorial Decision: Accept