title: Noncompliance in the use of cardiovascular medications in the Medicare Part D population.
abstract: OBJECTIVE
  (1) to assess non-compliance among Medicare Part D recipients for the cardiovascular  medication classes; (2) to identify the probability of noncompliance for each medication class when controlling for the  potential risk factors of age, gender, race/ethnic origin, census region, disease burden, dual eligibility enrollment  status, Part D plan status, relative out-of-pocket (OOP) non-class costs, and relative OOP daily class costs.
  
  
  METHODS
  Cross sectional retrospective review of 2007 Centers for Medicare & Medicaid Services (CMS) Part D data. All drugs within  a drug class were used to conduct the assessment.
  
  
  RESULTS
  Non-compliance was found to be lower than previously reported.  Patients who are male, age 65 to 74, Black, or residing in the South are associated with higher noncompliance for  cardiovascular medications among the therapeutic classes we studied. Dual eligibility enrollment is typically associated  with improved compliance; enrollment in a Medicare Advantage Prescription Drug (MAPD) plan may or may not improve  compliance dependent on the therapeutic class under study. Increased disease burden is associated with lower compliance.  OOP non-class costs had an opposing effect on compliance as compared to OOP daily costs; higher OOP non-class costs were  associated with better compliance.
  
  
  CONCLUSIONS
  Identifying patient characteristics that may contribute positively or  negatively to medication compliance is an essential step to improved therapy. As a strategy to improve compliance, the  proper selection of therapy that fits a particular patient is paramount.
authors.affiliation: US Department of Health and Human Services, Centers for Medicare & Medicaid Services, Baltimore, MD 21244, USA. sblackwell@cms.hhs.gov
authors.forename: Steven A
authors.initials: SA
authors.lastname: Blackwell
authors.forename: David K
authors.initials: DK
authors.lastname: Baugh
authors.forename: Melissa A
authors.initials: MA
authors.lastname: Montgomery
authors.forename: Gary M
authors.initials: GM
authors.lastname: Ciborowski
authors.forename: Charles J
authors.initials: CJ
authors.lastname: Waldron
authors.forename: Gerald F
authors.initials: GF
authors.lastname: Riley
mesh_terms: D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D002317:Cardiovascular Agents / Q000191:economics / Q000627:therapeutic use*; D002318:Cardiovascular Diseases / Q000188:drug therapy; D017281:Cost of Illness; D003430:Cross-Sectional Studies; D016527:Drug Costs / Q000706:statistics & numerical data; D005260:Female; D005382:Financing, Personal / Q000191:economics / Q000706:statistics & numerical data; D006801:Humans; D008297:Male; D020398:Medicare Part C / Q000706:statistics & numerical data; D054524:Medicare Part D / Q000706:statistics & numerical data*; D012189:Retrospective Studies; D012737:Sex Factors; D014481:United States; D016903:Drug Monitoring
chemical_list: D002317:Cardiovascular Agents