title: Relationship Between Medication Adherence and Distance to Dispensing Pharmacies and Prescribers Among an Urban Medicaid Population with Diabetes Mellitus.
abstract: To determine whether a relationship exists between medication adherence to angiotensin-converting enzyme inhibitors (ACEIs) and angiotensin II receptor blockers (ARBs) and distance to dispensing pharmacies and prescribers among an urban public aid population with diabetes mellitus.
  
  
  
  Retrospective cohort study using claims data.
  
  
  
  Illinois Department of Healthcare and Family Services database.
  
  
  
  A total of 6532 patients aged 18-64 years with diabetes who had at least one prescription fill for an ACEI or ARB and had continuous Medicaid coverage in the greater Chicago area in 2009.
  
  
  
  We assessed medication adherence, defined as proportion of days covered (PDC) of 0.8 or higher, to ACEIs and ARBs and its association with distances between patients and their pharmacies and prescribers. Of the 6532 patients included in the analyses, 2930 (45%) had PDC levels of 0.8 or higher. No significant differences were observed between patients who were adherent versus those who were nonadherent in distance to pharmacy (median 1.39 vs 1.35 miles, p=0.15) or distance to prescriber (median 4.39 vs 4.48 miles, p=0.80). In a multivariate regression model including age, sex, race/ethnicity, number of pharmacies, number of prescribers, distance to pharmacy, and distance to prescriber, a greater number of prescribers was associated with higher adherence (two prescribers vs one prescriber: odds ratio [OR] 1.396, 95% confidence interval [CI] 1.233-1.580; three or more prescribers vs one prescriber: OR 2.208, 95% CI 1.787-2.727).
  
  
  
  ACEI or ARB adherence was not associated with distances to pharmacies and prescribers.
authors.affiliation: Department of Medicine, University of Illinois at Chicago, Chicago, Illinois.
authors.forename: Samina T
authors.initials: ST
authors.lastname: Syed
authors.affiliation: Department of Medicine, University of Illinois at Chicago, Chicago, Illinois.|Institute for Health Research and Policy, University of Illinois at Chicago, Chicago, Illinois.|Department of Pharmacy Systems, Outcomes and Policy, College of Pharmacy, University of Illinois at Chicago, Chicago, Illinois.
authors.forename: Lisa K
authors.initials: LK
authors.lastname: Sharp
authors.affiliation: Institute for Health Research and Policy, University of Illinois at Chicago, Chicago, Illinois.
authors.forename: Yoonsang
authors.initials: Y
authors.lastname: Kim
authors.affiliation: Institute for Health Research and Policy, University of Illinois at Chicago, Chicago, Illinois.
authors.forename: Adam
authors.initials: A
authors.lastname: Jentleson
authors.affiliation: Department of Medicine, University of Illinois at Chicago, Chicago, Illinois.
authors.forename: Claudia M
authors.initials: CM
authors.lastname: Lora
authors.affiliation: Department of Pharmacy Systems, Outcomes and Policy, College of Pharmacy, University of Illinois at Chicago, Chicago, Illinois.
authors.forename: Daniel R
authors.initials: DR
authors.lastname: Touchette
authors.affiliation: Institute for Health Research and Policy, University of Illinois at Chicago, Chicago, Illinois.
authors.forename: Michael L
authors.initials: ML
authors.lastname: Berbaum
authors.affiliation: Department of Pharmacy Systems, Outcomes and Policy, College of Pharmacy, University of Illinois at Chicago, Chicago, Illinois.|Center of Innovation for Complex Chronic Healthcare, Hines VA Medical Center, Hines, Illinois.
authors.forename: Katie J
authors.initials: KJ
authors.lastname: Suda
authors.affiliation: Department of Medicine, University of Illinois at Chicago, Chicago, Illinois.|Institute for Health Research and Policy, University of Illinois at Chicago, Chicago, Illinois.|Center of Innovation for Complex Chronic Healthcare, Jesse Brown VA Medical Center, Chicago, Illinois.
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; D016208:Databases, Factual; D003920:Diabetes Mellitus / Q000188:drug therapy; D005260:Female; D062306:Geography, Medical / Q000706:statistics & numerical data*; D006801:Humans; D008297:Male; D008875:Middle Aged; D010594:Pharmacies / Q000706:statistics & numerical data*; D010820:Physicians / Q000706:statistics & numerical data*; D012189:Retrospective Studies; D014505:Urban Population / Q000706:statistics & numerical data*; D055815:Young Adult; D016903:Drug Monitoring
chemical_list: D057911:Angiotensin Receptor Antagonists; D000806:Angiotensin-Converting Enzyme Inhibitors
keywords: angiotensin II receptor blocker; angiotensin-converting enzyme inhibitor; diabetes mellitus; health services accessibility; medication adherence; transportation