Back to Annual Meeting Page		American Public Health Association 133rd Annual Meeting & Exposition December 10-14, 2005 Philadelphia, PA

Abstract #103928

Joseph R. Sharkey, PhD, MPH, RD, School of Rural Public Health, Texas A&M University System Health Science Center, 1103 University Drive, Suite 203, College Station, TX 77840, (979) 458-4268, sharkey@tamu.edu, Marcia G. Ory, PhD, MPH, School of Rural Public Health - Department of Social and Behavioral Health, Texas A & M University System Health Science Center, 3000 Briarcrest Drive, Suite 310, Bryan, TX 77802, Barry A. Browne, PharmD, Department of Pharmacy, Scott & White Hospital, 2401 S. 31st St, Temple, TX 76508, and Suojin Wang, PhD, Department of Statistics, Texas A&M University, TAMU-3143, College Station, TX 77845-3143.

OBJECTIVES: To examine the extent to which strategies adopted by homebound older adults to reduce or restrict out-of-pocket prescription medication cost persist over time. METHODS: Multivariate logistic regression models were employed to examine the magnitude and correlates – sample characteristics, drug coverage, consistent use of behaviors to cope with out-of-pocket drug expense, and increased difficulty paying for medications – for continued use of strategies to reduce or restrict medication cost in 177 randomly recruited homebound older adults who completed two in-home assessments (baseline and 1-year follow-up). RESULTS: At 1-year assessment, 19% of participants used ≥1 behavior that restricted medication use (11% at both assessments); 24% (18% at both assessments) used ≥1 strategy to reduce out-of-pocket medication cost, and 17% perceived great difficulty paying for drugs (10% at both assessments). Restricting medication use at 1 year was more likely among elders who had reduced out-of-pocket medication cost (OR = 5.3, 95% CI: 1.2-22.4) or restricted medication use (OR = 10.7, 95% CI: 3.0-37.6) at baseline or reported great difficulty paying for medications (OR = 11.9, 95% CI: 3.6-39.9) at 1 year. Perception of great difficulty paying for medications at 1 year was associated with consistently having to choose between purchasing food and drugs, having no drug coverage, or using the largest number of unique medications. CONCLUSION: Efforts are needed to identify older individuals at risk for medication self-restriction and develop strategies for minimizing cost-related behaviors, especially those that persist over time, that may threaten adherence to medication regimens.

Learning Objectives:

• List strategies that older adults adopt to reduce or restrict out-of-pocket medication cost.
• Articulate the factors that cause these behaviors to persist over time.

Keywords: Behavior Modification, Adherence

Presenting author's disclosure statement:

I wish to disclose that I have NO financial interests or other relationship with the manufactures of commercial products, suppliers of commercial services or commercial supporters.

Recorded presentation