title: Does Cost-Related Medication Nonadherence among Cardiovascular Disease Patients Vary by Gender? Evidence from a Nationally Representative Sample.
abstract: Cardiovascular disease (CVD) is a leading cause of death and disability as well as a major burden on the U.S. healthcare system. Cost-related medication nonadherence (CRN) to prescribed medications is common among patients with CVD. This study examines the gender differences in CRN among CVD patients.
  
  
  
  We used 2011 to 2014 data from the National Health Interview Survey, an annual, cross-sectional, nationally representative household survey of the noninstitutionalized U.S. civilian population (≥18 years of age). Based on Andersen's model of health services utilization, multivariate logistic regressions were estimated to examine the effect of gender on the primary composite outcome of CRN which was identified if any of the following types of CRN were reported: 1) skipped medication doses to save money, 2) took less medication to save money, and 3) delayed prescription filling to save money.
  
  
  
  Among CVD patients who had used a prescription medication in the last 12 months, 10.0% skipped medication doses, 10.6% took less medication, and 12.8% delayed filling their prescriptions. After adjusting for confounding factors, gender was found to be significantly associated with the composite outcome of CRN among CVD patients. Women were 1.54 times (95% confidence interval, 1.33-1.77) more likely to have any of the types of CRN compared with men.
  
  
  
  There are significant gender disparities in CRN among CVD patients. More support for and closer monitoring of CRN is needed for disadvantaged groups, especially women with limited resources.
authors.affiliation: School of Public Health, The University of Memphis, Memphis, Tennessee. Electronic address: sbhuyan@memphis.edu.
authors.forename: Soumitra S
authors.initials: SS
authors.lastname: Bhuyan
authors.affiliation: School of Pharmacy, University of Wisconsin, Madison, Wisconsin.
authors.forename: Olayinka
authors.initials: O
authors.lastname: Shiyanbola
authors.affiliation: School of Public Health, The University of Memphis, Memphis, Tennessee.
authors.forename: Satish
authors.initials: S
authors.lastname: Kedia
authors.affiliation: University of Nebraska Medical Center, Omaha, Nebraska.
authors.forename: Aastha
authors.initials: A
authors.lastname: Chandak
authors.affiliation: Joseph J. Zilber School of Public Health, University of Wisconsin-Milwaukee, Milwaukee, Wisconsin.
authors.forename: Yang
authors.initials: Y
authors.lastname: Wang
authors.affiliation: School of Public Health, The University of Memphis, Memphis, Tennessee.
authors.forename: Oluwaseyi O
authors.initials: OO
authors.lastname: Isehunwa
authors.affiliation: School of Public Health, The University of Memphis, Memphis, Tennessee.
authors.forename: Nnamdi
authors.initials: N
authors.lastname: Anunobi
authors.affiliation: King's College London, and London School of Hygiene and Tropical Medicine, London, United Kingdom.
authors.forename: Ikenna
authors.initials: I
authors.lastname: Ebuenyi
authors.affiliation: University of Nebraska Medical Center, Omaha, Nebraska.
authors.forename: Pallav
authors.initials: P
authors.lastname: Deka
authors.affiliation: School of Public Health, The University of Memphis, Memphis, Tennessee.
authors.forename: SangNam
authors.initials: S
authors.lastname: Ahn
authors.affiliation: Fogelman College of Business and Economics, The University of Memphis, Memphis, Tennessee.
authors.forename: Cyril F
authors.initials: CF
authors.lastname: Chang
mesh_terms: D000328:Adult; D000368:Aged; D002318:Cardiovascular Diseases / Q000188:drug therapy* / Q000191:economics; D003430:Cross-Sectional Studies; D016527:Drug Costs / Q000706:statistics & numerical data*; D005260:Female; D005102:Health Expenditures; D006801:Humans; D007348:Insurance, Health; D008297:Male; D008875:Middle Aged; D055553:Prescription Drugs / Q000191:economics*; D012737:Sex Factors; D016903:Drug Monitoring
chemical_list: D055553:Prescription Drugs