Comparing Medication Adherence Rates Between Pharmacy Desert and Non-Desert Areas Among Elderly in Pennsylvania

Pednekar, Priti; Peterson, Anne; Heller, Debra A.

doi:10.1016/j.jval.2016.03.1253

Cited by 4 publications

(5 citation statements)

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“…Findings revealed that structural inequities and systemic racism contribute to pharmacy desert genesis in Los Angeles 3. Findings are consistent with those described in a Pennsylvania study that compared medication adherence rates of seniors between pharmacy desert and nondesert areas 4. This retrospective observational cohort study revealed that medication adherence rates are influenced by pharmacy desert presence and SDoH, including vehicle access and income levels.…”

supporting

confidence: 83%

“…3 Findings are consistent with those described in a Pennsylvania study that compared medication adherence rates of seniors between pharmacy desert and nondesert areas. 4 This retrospective observational cohort study revealed that medication adherence rates are influenced by pharmacy desert presence and SDoH, including vehicle access and income levels. Qato et al 5 identified pharmacy deserts in 2014 as a prevalent concern for minority communities living in Chicago and found that lack of pharmacy resources was greatest in segregated minority communities and that this deficiency adversely affects medication access and other frequently delivered pharmacy services.…”

mentioning

confidence: 97%

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Healthy Resource Deserts

Zuzelo¹

2021

Holistic Nursing Practice

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Ongoing concerns with the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic and its associated variant strains, commonly and collectively referred to as COVID-19, combined with the Black Lives Matter movement, have encouraged conversations and analyses from diverse sources about unfair and inequitable access to health resources, particularly those influenced by the social determinants of health (SDoH). A discussion paper by the National Academies of Medicine offers an excellent resource for health care professionals that is informed by the World Health Organization's SDoH definition 1 : specifically, the situations in which people are born and live their lives. These circumstances are influenced by global, national, and local power and resource distributions. 1 Health professionals recognize that SDoH directly and indirectly affect individual and community health outcomes that are largely influenced by the context within which health opportunities exist along a continuum of entirely unavailable to abundantly present. This continuum is affected by socioeconomic status that is associated with race/ethnicity, age, and other key demographics. Many people live their lives in neighborhoods devoid of readily accessible healthy food and pharmacies, geographic areas that might be reasonably described as healthy resource deserts. Nurses and other health

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supporting

confidence: 83%

mentioning

confidence: 97%

Healthy Resource Deserts

Zuzelo¹

2021

Holistic Nursing Practice

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“…13 The travel distance (in km) was estimated using Bing maps, a Microsoft Cloud Service. Distance to the closest pharmacy is used to identify pharmacy desert areas (i.e., zip code where the possibility to access pharmacy services is limited or absent; Pednekar & Peterson, 2018;Pednekar, Peterson, & Heller, 2016;Qin, Diniz, & Coleman, 2018). Specifically, we defined a threshold that takes into account for the differences between urban pharmacy desert and rural pharmacy desert due to the lack of public transportation and greater spatial dispersion of resources.…”

Section: Geographic Barriers: Distance and Pharmacy Desertmentioning

confidence: 99%

Older patients and geographic barriers to pharmacy access: When nonadherence translates to an increased use of other components of health care

2020

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This paper studies whether geographic barriers can influence nonadherence to prescription drugs and its effect on patients' health. We used a multivariate probit model estimated by maximum simulated likelihood that considers individual unobserved heterogeneity, which may characterize the relationship between adherence, medical care utilization, and health outcome. We used administrative data from Liguria, Italy, the region with the highest rate of individuals over the age of 65 in Europe. Our sample included older individuals affected by cardiovascular diseases, which remain one of the leading causes of death in most OECD countries. Our results showed that geographic barriers to pharmacies negatively influence patients' adherence. According to our results, patients' nonadherence to pharmacological therapy is responsible for an increased probability of patients' mortality and the overuse of other medical services, namely, hospitalizations and emergency department visits. Nonadherence may thus represent a potential source of waste for the health care system.

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“…In particular, black and Hispanic patients,16 17 patients with low socioeconomic status,18 those who lack social support, and have complex treatment regimen19 20 often face higher barriers to maintaining optimal adherence. These barriers are further exacerbated by therapy-related factors, such as copayment21 and neighbourhood-level factors, such as pharmacy access 22…”

Section: Introductionmentioning

confidence: 99%

“…These barriers are further exacerbated by therapy-related factors, such as copayment 21 and neighbourhood-level factors, such as pharmacy access. 22 …”

Section: Introductionmentioning

confidence: 99%

Cohort profile: a large EHR-based cohort with linked pharmacy refill and neighbourhood social determinants of health data to assess heart failure medication adherence

Adhikari,

Mukhyopadhyay,

Kolzoff

et al. 2023

BMJ Open

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PurposeClinic-based or community-based interventions can improve adherence to guideline-directed medication therapies (GDMTs) among patients with heart failure (HF). However, opportunities for such interventions are frequently missed, as providers may be unable to recognise risk patterns for medication non-adherence. Machine learning algorithms can help in identifying patients with high likelihood of non-adherence. While a number of multilevel factors influence adherence, prior models predicting non-adherence have been limited by data availability. We have established an electronic health record (EHR)-based cohort with comprehensive data elements from multiple sources to improve on existing models. We linked EHR data with pharmacy refill data for real-time incorporation of prescription fills and with social determinants data to incorporate neighbourhood factors.ParticipantsPatients seen at a large health system in New York City (NYC), who were >18 years old with diagnosis of HF or reduced ejection fraction (<40%) since 2017, had at least one clinical encounter between 1 April 2021 and 31 October 2022 and active prescriptions for any of the four GDMTs (beta-blocker, ACEi/angiotensin receptor blocker (ARB)/angiotensin receptor neprilysin inhibitor (ARNI), mineralocorticoid receptor antagonist (MRA) and sodium-glucose cotransporter 2 inhibitor (SGLT2i)) during the study period. Patients with non-geocodable address or outside the continental USA were excluded.Findings to dateAmong 39 963 patients in the cohort, the average age was 73±14 years old, 44% were female and 48% were current/former smokers. The common comorbid conditions were hypertension (77%), cardiac arrhythmias (56%), obesity (33%) and valvular disease (33%). During the study period, 33 606 (84%) patients had an active prescription of beta blocker, 32 626 (82%) had ACEi/ARB/ARNI, 11 611 (29%) MRA and 7472 (19%) SGLT2i. Ninety-nine per cent were from urban metropolitan areas.Future plansWe will use the established cohort to develop a machine learning model to predict medication adherence, and to support ancillary studies assessing associates of adherence. For external validation, we will include data from an additional hospital system in NYC.

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Comparing Medication Adherence Rates Between Pharmacy Desert and Non-Desert Areas Among Elderly in Pennsylvania

Cited by 4 publications

References 0 publications

Healthy Resource Deserts

Healthy Resource Deserts

Older patients and geographic barriers to pharmacy access: When nonadherence translates to an increased use of other components of health care

Cohort profile: a large EHR-based cohort with linked pharmacy refill and neighbourhood social determinants of health data to assess heart failure medication adherence

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