title: Risk factors for cost-related medication non-adherence among older patients with cancer.
abstract: We aimed to assess the risk factors for cost-related medication non-adherence (CRN) among older patients with cancer in the United States. We used data from the 2010 Health and Retirement Study (HRS) to assess risk factors for CRN including age, insurance coverage, nursing home residence, functional limitations, and frequency of hospitalization among old patients with cancer. CRN was self-reported. We conducted a multivariate regression analysis to assess the effect of each risk factor. 293 (9.9%) of 2,953 older patients (50+ years) cancer patients reported CRN. Those who reported CRN were more likely to be younger, women, African American, and Hispanics. Compared to those with Medicare, those with no health insurance coverage were 97% more likely to report CRN. High number in limitation in activities of daily living and hospitalization significantly increased risk for CRN. Sicker cancer patients were more likely to report CRN. Lack of health insurance may have prevented the cancer patients from receiving optimal care. Together, these results suggest that expanding insurance coverage and improving insurance benefit design for cancer patients is likely to decrease CRN and improve outcomes.
authors.affiliation: Section of Hospital Medicine, Department of Medicine, The University of Chicago, USA.
authors.forename: James X
authors.initials: JX
authors.lastname: Zhang
authors.affiliation: Section of Hospital Medicine, Department of Medicine, The University of Chicago, USA; Department of Economics, The University of Chicago, USA; Harris School of Public Policy, The University of Chicago, USA.
authors.forename: David O
authors.initials: DO
authors.lastname: Meltzer
keywords: medication adherence; risk factors