title: Influence of patient sex and gender on medication use, adherence, and prescribing alignment with guidelines.
abstract: BACKGROUND
  This study evaluates the differences between women and men in medication use, medication adherence, and prescribing alignment with clinical guidelines.
  
  
  METHODS
  We conducted an analysis of pharmacy and medical claims for 29.5 million adults with prescription benefits administered by a pharmacy benefits manager in the United States, age 18 and older, between January 1, 2010, and December 31, 2010. Prevalence and intensity of medication use were evaluated by sex, age group, and medication type (acute vs. chronic). Medication adherence was measured by the percentage of patients with a medication possession ratio (MPR) ≥80%. The percentage of patients receiving guideline-based treatment was measured for diabetes and select cardiovascular conditions.
  
  
  RESULTS
  The study population comprised 16.0 million women and 13.5 million men with continuous pharmacy benefit eligibility. Women were significantly more likely than men to use one or more medications during the analysis period (68% vs. 59%, respectively, p<0.001), and women used more unique medications, on average, than men (5.0 vs. 3.7 medications per year, respectively, p<0.001). Differences in drug utilization were observed for all age groups and medication types. For all clinical metrics evaluated, women were less likely than men to be adherent in their use of chronic medications, and they were less likely to receive the medication treatment and monitoring recommended by clinical guidelines.
  
  
  CONCLUSIONS
  There are significant disparities between women and men in their intensity of medication use, their adherence to medications, and their likelihood of receiving guideline-based drug therapy. These differences may indicate a need for more personalized drug selection and therapeutic management to improve clinical outcomes.
authors.affiliation: 1 Society for Women's Health Research , Washington, DC.
authors.forename: Marie
authors.initials: M
authors.lastname: Manteuffel
authors.forename: Sophy
authors.initials: S
authors.lastname: Williams
authors.forename: William
authors.initials: W
authors.lastname: Chen
authors.forename: Robert R
authors.initials: RR
authors.lastname: Verbrugge
authors.forename: Donald G
authors.initials: DG
authors.lastname: Pittman
authors.forename: Amy
authors.initials: A
authors.lastname: Steinkellner
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D002318:Cardiovascular Diseases / Q000188:drug therapy; D003920:Diabetes Mellitus / Q000188:drug therapy; D004363:Drug Utilization / Q000706:statistics & numerical data*; D005260:Female; D005783:Gender Identity; D006801:Humans; D007356:Insurance, Pharmaceutical Services / Q000191:economics / Q000706:statistics & numerical data; D008297:Male; D008875:Middle Aged; D017410:Practice Guidelines as Topic; D010818:Practice Patterns, Physicians'; D055553:Prescription Drugs / Q000008:administration & dosage* / Q000191:economics; D055656:Prescriptions / Q000191:economics / Q000706:statistics & numerical data*; D015995:Prevalence; D012737:Sex Factors; D055815:Young Adult; D016903:Drug Monitoring
chemical_list: D055553:Prescription Drugs