title: Are sample medicines hurting the uninsured?
abstract: BACKGROUND
  Pharmaceutical representatives often give sample medications to physicians for distribution to patients. In chronic conditions such as hypertension, this practice can contribute to unnecessary medication changes, gaps in treatment, and inferior control of disease. The objective of the current study was to explore associations between use of free sample medicine, hypertension, and source of payment for health care.
  
  
  METHODS
  Telephone interviews and chart reviews were conducted at two community health centers in California. Adults with hypertension who had at least three clinic visits in the previous year and either had no insurance or had Medicare or Medicaid were included.
  
  
  RESULTS
  Seventy-one patients participated. Seventeen had received sample medicines up to three times within the previous year. Lack of insurance (P < .01) was associated with sample medicine use. No group differences were found for medication changes. In multiple regression analysis, uninsured patients who received sample medicines had higher diastolic blood pressure (P = .01).
  
  
  CONCLUSIONS
  Lack of insurance was the principle predictor of use of sample medications. Although cross-sectional design and covariance of independent variables limit conclusions, higher diastolic blood pressure was related to sample medication use in patients who did not have insurance.
mesh_terms: D000959:Antihypertensive Agents / Q000191:economics / Q000627:therapeutic use; D002140:California; D003430:Cross-Sectional Studies; D003625:Data Collection / Q000379:methods; D011307:Drug Prescriptions / Q000191:economics*; D005260:Female; D006297:Health Services Accessibility / Q000191:economics*; D006801:Humans; D006973:Hypertension / Q000188:drug therapy / Q000191:economics; D008297:Male; D008484:Medicaid; D017057:Medically Uninsured; D006278:Medicare; D008875:Middle Aged; D010818:Practice Patterns, Physicians'; D012044:Regression Analysis; D014481:United States
chemical_list: D000959:Antihypertensive Agents