Cost-Related Medication Behaviors for Patients With and Without Systemic Autoimmune Rheumatic Diseases.

IF 3.7 2区 医学 Q1 RHEUMATOLOGY Arthritis Care & Research Pub Date : 2024-09-23 DOI:10.1002/acr.25442
Jeong Yee, Candace H Feldman, Emily G Oakes, Jack Ellrodt, Hongshu Guan, May Y Choi, Elizabeth W Karlson, Karen H Costenbader
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Abstract

Objective: Medication nonadherence challenges the management of systemic autoimmune rheumatic diseases (SARDs). We investigated cost-related medication behaviors among patients with SARDs, and compared them to those of patients without SARDs, in a large diverse cohort across the United States.

Methods: As part of the All of Us (version 7), a nationwide diverse adult cohort with linked electronic health records begun in 2017, participants completed questionnaires concerning cost-related medication behaviors. Chi-square tests compared responses between patients with SARDs, by disease and medication type, and to those without SARDs. Logistic regression analyses were used to calculate odds ratios (95% confidence intervals [CIs]).

Results: We analyzed data from 3,997 patients with SARDs and 73,990 participants without SARDs. After adjustment, patients with versus without SARDs had 1.56 times increased odds of reporting unaffordability of prescription medicines (95% CI 1.43-1.70), 1.43 times increased odds of cost-related medication nonadherence (95% CI 1.31-1.56), and 1.23 times increased odds of using cost-reducing strategies (95% CI 1.14-1.32). Patients with SARDs who reported unaffordability were 16.5% less likely to receive a disease-modifying drug (95% CI 0.70-0.99) but 18.1% more likely to receive glucocorticoids (95% CI 0.99-1.42). In addition, unaffordability of prescription medicines was likely to have 1.27 times increased odds of one to two emergency room visits per year (95% CI 1.03-1.57) and 1.38-fold increased odds of three or more emergency room visits per year (95% CI 0.96-1.99).

Conclusion: In this large diverse cohort, patients with versus without SARDs had more self-reported cost-related medication behaviors, and those who reported medication unaffordability received fewer disease-modifying drugs and had more emergency room visits.

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系统性自身免疫性风湿病患者和非系统性自身免疫性风湿病患者与费用相关的用药行为。
目的:不遵医嘱用药给系统性自身免疫性风湿病(SARDs)的治疗带来了挑战。我们调查了全美大量不同人群中患有系统性自身免疫性风湿病的患者与费用相关的用药行为,并与未患有系统性自身免疫性风湿病的患者进行了比较:作为 "我们所有人研究(All of Us)计划"(第 7 版)的一部分,参与者填写了与费用相关的用药行为调查问卷。通过卡方检验比较了患有 SARDs 的患者(按疾病和药物类型划分)和未患有 SARDs 的患者之间的回答。逻辑回归分析用于计算几率比(ORs,95% 置信区间):我们分析了 3,997 名 SARDs 患者和 73,990 名无 SARDs 患者的数据。经过调整后,患有 SARDs 的患者与未患有 SARDs 的患者相比,报告无法负担处方药的几率增加了 1.56 倍(95%CI 1.43-1.70),与费用相关的不坚持用药几率增加了 1.43 倍(95%CI 1.31-1.56),使用降低费用策略的几率增加了 1.23 倍(95%CI 1.14-1.32)。报告负担不起的 SARDs 患者接受改变病情药物治疗的可能性降低了 16.5%(95%CI 0.70-0.99),但接受糖皮质激素治疗的可能性增加了 18.1%(95%CI 0.99-1.42)。此外,负担不起处方药可能会使1-2次和≥3次/年急诊就诊的几率分别增加1.27倍(95%CI 1.03-1.57)和1.38倍(95%CI 0.96-1.99):在这一大型多样化队列中,患有 SARDs 的患者与未患有 SARDs 的患者相比,自我报告与费用相关的用药行为更多,那些报告用药负担不起的患者使用的疾病调整药物更少,急诊就诊次数更多。
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来源期刊
CiteScore
9.40
自引率
6.40%
发文量
368
审稿时长
3-6 weeks
期刊介绍: Arthritis Care & Research, an official journal of the American College of Rheumatology and the Association of Rheumatology Health Professionals (a division of the College), is a peer-reviewed publication that publishes original research, review articles, and editorials that promote excellence in the clinical practice of rheumatology. Relevant to the care of individuals with rheumatic diseases, major topics are evidence-based practice studies, clinical problems, practice guidelines, educational, social, and public health issues, health economics, health care policy, and future trends in rheumatology practice.
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