Cost Barriers Influence Adherence to Asthma Care

TOPLINE:

Nearly one in six adults with asthma in the United States is nonadherent to medications due to costs, with younger patients, women, and those without insurance having an increased likelihood of being nonadherent.

METHODOLOGY:

• Researchers evaluated the prevalence and determinants of cost-related nonadherence (CRN) to medications among adults with asthma in the United States between 2011 and 2022. Data were obtained from the National Health Interview Survey (NHIS) conducted by the National Center for Health Statistics.
• They used the data from the NHIS to include a total of 30,793 adults who had asthma, representing 8.1% of the US population.
• CRN was defined through three components: Skipping medication doses, taking less medication, or delaying medication refills to save money over the past 12 months.
• CRN prevalence, factors associated with CRN, and asthma-related adverse events were analyzed.

TAKEAWAY:

• Overall, 17.8% of US adults with asthma reported CRN; 11.6% skipped medication, 12.4% took less medication, and 15.1% delayed refilling medications to save money.
• Patients aged > 60 years were the least likely to report CRN compared with those aged 18-40 years and 41-60 years; women were more likely to report CRN to medications than men (both P
• Patients who were current or former smokers or had two or more comorbidities, no health insurance coverage, or a family income below 400% of the federal poverty level had an increased likelihood of reporting CRN.
• Compared with patients without CRN, those who reported CRN had almost double the odds of experiencing asthma attacks (adjusted odds ratio [aOR], 1.95; 95% CI, 1.78-2.13) and increased emergency room visits for asthma (aOR, 1.63; 95% CI, 1.44-1.84).

IN PRACTICE:

“The present study reinforces the recommendation that patients with asthma are best controlled when they are prescribed and take medications that are strongly recommended by clinical guidelines,” the authors wrote. “For healthcare providers, it is imperative to monitor patient’s adherence to medications to prevent asthma exacerbations, especially when treating patients with financial concerns,” they further added.

SOURCE:

The study was led by Chun-Tse Hung, School of Pharmacy, College of Pharmacy, Taipei Medical University, Taipei, Taiwan. It was published online on December 9, 2024, in Thorax.

LIMITATIONS:

The reliance on self-reported data introduced potential recall bias, and the absence of medical records may have led to misclassification of disease status. The study could not evaluate the effect of asthma severity due to limited measures in the NHIS. Some important variables reflecting economic indicators, such as the consumer price index, could not be included due to limited measures in the NHIS.

DISCLOSURES

No disclosures or conflicts of interest statements were provided in the study.

This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.