title: ACE inhibitor and ARB medication use among Medicaid enrollees with diabetes.
abstract: OBJECTIVE
  To examine ace-inhibitor (ACEI) and angiotensin receptor blockers (ARB) prescription and adherence patterns by race in diabetic public aid recipients.
  
  
  METHODS
  We analyzed prescription records of 27,529 adults aged 18-64 with diabetes who had at least one clinical indication for receiving an ACEI/ ARB prescription and were enrolled in the State of Illinois public aid program during 2007. We calculated proportion of days covered (PDC) to assess adherence. Multivariate models adjusted for age, sex, ACEI/ARB indication, and any significant interaction terms.
  
  
  RESULTS
  Only 47.4% of individuals with at least one indication for ACEI/ARB had filled an ACEI/ARB prescription. African American men were more likely than Caucasian men to ever fill an ACEI/ARB prescription (adjusted odds ratio, [AOR] [95% CI] 1.69 [1.55-1.83]). Hispanic English and Spanish speaking men were also more likely than Caucasian men to ever fill an ACEI/ARB prescription (AOR [95% CI] 1.37 [1.16-1.62] and 1.27 [1.05-1.53], respectively). Similarly, African American and Hispanic English and Spanish speaking women were more likely than Caucasian women to ever fill an ACEI/ARB prescription (AOR [95% CI] 1.70 [1.59-1.81], 1.55 (1.36-1.76), and 1.98 (1.73-2.28), respectively. However, African Americans and Hispanics were less likely than Caucasians to achieve a PDC> or =80%. Compared to Caucasians, Hispanic Spanish speakers were the least likely to be adherent (AOR [95% CI] .49 [.41-.58]). Furthermore, older individuals were more likely to achieve a PDC> or =80% than younger individuals.
  
  
  CONCLUSIONS
  African Americans and Hispanics with diabetes receiving public aid in Illinois were more likely than Caucasians to have filled at least one ACEI/ARB prescription. However, they were less adherent with these medications. Future studies should assess barriers to medication adherence in this population.
authors.affiliation: Department of Medicine, Section of Nephrology, 820 S. Wood Street M/C 793, Chicago, IL 60612, USA. cloral@uic.edu
authors.forename: Claudia M
authors.initials: CM
authors.lastname: Lora
authors.forename: Alexander W
authors.initials: AW
authors.lastname: Sokolovsky
authors.forename: Daniel R
authors.initials: DR
authors.lastname: Touchette
authors.forename: Jing
authors.initials: J
authors.lastname: Jin
authors.forename: Xiaojing
authors.initials: X
authors.lastname: Hu
authors.forename: Weihua
authors.initials: W
authors.lastname: Gao
authors.forename: Ben S
authors.initials: BS
authors.lastname: Gerber
mesh_terms: D000293:Adolescent; D000328:Adult; D057911:Angiotensin Receptor Antagonists / Q000627:therapeutic use*; D000806:Angiotensin-Converting Enzyme Inhibitors / Q000627:therapeutic use*; D003920:Diabetes Mellitus / Q000188:drug therapy* / Q000191:economics / Q000208:ethnology*; D017723:Drug Utilization Review; D005260:Female; D006801:Humans; D007087:Illinois; D008297:Male; D008484:Medicaid; D055118:Medication Adherence / Q000208:ethnology*; D008875:Middle Aged; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data*; D014481:United States; D055815:Young Adult
chemical_list: D057911:Angiotensin Receptor Antagonists; D000806:Angiotensin-Converting Enzyme Inhibitors