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首页> 外文期刊>Patient Preference and Adherence >Out-of-pocket costs and adherence to antihypertensive agents among older adults covered by the public drug insurance plan in Quebec
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Out-of-pocket costs and adherence to antihypertensive agents among older adults covered by the public drug insurance plan in Quebec

机译：魁北克公共药物保险计划涵盖的老年人的自付费用和坚持服用降压药

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Objective: To evaluate the effect of patient out-of-pocket costs on adherence to antihypertensive agents (AHA) in community-dwelling older adults covered by the public drug insurance plan in Quebec. Methods: This is a secondary analysis of data from the “étude sur la santé des a?nés” study (2005–2008) on community-dwelling older adults in Quebec aged 65 years and older (N=2,811). The final sample included 881 participants diagnosed with arterial hypertension and treated with AHA. Medication adherence was measured with the proportion of days covered over a 2-year follow-up period (<80% and ≥80%). Out-of-pocket costs for AHA, in Canadian dollars (CAD), at cohort entry were categorized as follows: $0, $0.01–$5.00, $5.01–$10.00, $10.01–$15.00 and $15.01–$36.00. Multivariable logistic regression models were constructed to study adherence to AHA as a function of out-of-pocket costs while controlling for several confounders. Models were also stratified by annual household income (<$15,000 CAD and ≥$15,000 CAD). Results: In this study, 80.8% of participants were adherent to their AHA. Among participants reporting an annual household income <$15,000 CAD, those with an out-of-pocket cost?of $10.01–$15.00 CAD were significantly less adherent to their AHA than those with no contribution (OR?=0.175, 95% CI: 0.042–0.740). Among participants reporting an income of ≥$15,000 CAD, those with out-of-pocket costs of $0.01–$5.00 CAD (OR =0.194; 95% CI: 0.048–0.787), $5.01–$10.00 CAD (OR =0.146; 95% CI: 0.036–0.589), $10.01–$15.00 CAD (OR =0.192; 95%?CI: 0.047–0.777) and $15.01–$36.00 CAD (OR =0.160, 95% CI: 0.039–0.655) were significantly less adherent to their AHA than participants with no contribution. Conclusion: Increased out-of-pocket costs are associated with non-adherence to AHA in older adults covered by a public drug insurance plan, more importantly in those reporting an annual household income ≥$15,000 CAD. A reduction in the amount of out-of-pocket costs and yearly maximum contribution for drugs may improve adherence to treatment.
机译：目的：评估魁北克公共药物保险计划涵盖的社区自付费用的患者自付费用对坚持使用降压药（AHA）的影响。方法：这是对“étudesur lasantédes a？nés”研究（2005-2008年）中魁北克年龄在65岁及以上（N = 2,811）的社区居住老年人的数据的二次分析。最终样本包括881名被诊断患有动脉高血压并接受AHA治疗的参与者。药物依从性以两年随访期（<80％和≥80％）的天数来衡量。队列进入时以加元（CAD）支付的AHA自付费用分类如下：$ 0，$ 0.01- $ 5.00，$ 5.01- $ 10.00，$ 10.01- $ 15.00和$ 15.01- $ 36.00。构建了多变量logistic回归模型，以研究自付费用的依从性，同时控制多个混杂因素。还按家庭年收入（<$ 15,000加元和≥$ 15,000加元）对模型进行了分层。结果：在这项研究中，80.8％的参与者遵守了他们的AHA。在报告的家庭年收入低于$ 15,000加元的参与者中，自付费用为$ 10.01– $ 15.00 CAD的参与者对AHA的依从性明显低于没有贡献的参与者（OR？= 0.175，95％CI：0.042– 0.740）。在报告收入≥15,000加元的参与者中，自付费用在0.01-5.00加元（或= 0.194; 95％CI：0.048-0.787），5.01-1.00加元（OR = 0.146; 95％CI： 0.036–0.589），$ 10.01– $ 15.00 CAD（OR = 0.192; 95％？CI：0.047–0.777）和$ 15.01– $ 36.00 CAD（OR = 0.160，95％CI：0.039–0.655）与参与者相比，AHA依从性显着降低没有贡献。结论：自付费用的增加与公共药物保险计划所覆盖的老年人不遵守AHA有关，更重要的是，其家庭年收入≥15,000加元的人。自付费用的减少和每年对药物的最高供款可提高对治疗的依从性。

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