City Research Online

Patient-reported financial barriers to adherence to treatment in neurology

Moura, L. M. V. R., Schwamm, E. L., Moura Junior, V. ORCID: 0000-0001-5735-9143, Seitz, M. P., Hoch, D., Hsu, J. and Schwamm, L. H. (2016). Patient-reported financial barriers to adherence to treatment in neurology. ClinicoEconomics and Outcomes Research, 8, pp. 685-694. doi: 10.2147/CEOR.S119971

Abstract

OBJECTIVE: Many effective medical therapies are available for treating neurological diseases, but these therapies tend to be expensive and adherence is critical to their effectiveness. We used patient-reported data to examine the frequency and determinants of financial barriers to medication adherence among individuals treated for neurological disorders.

PATIENTS AND METHODS: Patients completed cross-sectional surveys on iPads as part of routine outpatient care in a neurology clinic. Survey responses from a 3-month period were collected and merged with administrative sources of demographic and clinical information (eg, insurance type). We explored the association between patient characteristics and patient-reported failure to refill prescription medication due to cost in the previous 12 months, termed here as "nonadherence".

RESULTS: The population studied comprised 6075 adults who were presented between July and September 2015 for outpatient neurology appointments. The mean age of participants was 56 (standard deviation: 18) years, and 1613 (54%) were females. The patients who participated in the surveys (2992, 49%) were comparable to nonparticipants with respect to gender and ethnicity but more often identified English as their preferred language (94% vs 6%, p<0.01). Among respondents, 9.8% (n=265) reported nonadherence that varied by condition. These patients were more frequently Hispanic (16.7% vs 9.8% white, p=0.01), living alone (13.9% vs 8.9% cohabitating, p<0.01), and preferred a language other than English (15.3% vs 9.4%, p=0.02).

CONCLUSION: Overall, the magnitude of financial barriers to medication adherence appears to vary across neurological conditions and demographic characteristics.

Publication Type: Article
Publisher Keywords: outcomes, adherence, cost
Subjects: H Social Sciences > HD Industries. Land use. Labor > HD28 Management. Industrial Management
R Medicine > RC Internal medicine > RC0321 Neuroscience. Biological psychiatry. Neuropsychiatry
Departments: Cass Business School > Management
URI: http://openaccess.city.ac.uk/id/eprint/20443
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