Geospatial Analysis of Statin Adherence Using Pharmacy Claims Data in the State of Michigan

Erickson, Steven R.; Lin, Yuan Nung Tony

doi:10.18553/jmcp.2014.20.12.1208

Cited by 9 publications

(7 citation statements)

References 46 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…6 A previous study by the investigators found that statin adherence varies significantly across the State of Michigan for an insured sample of patients taking statin therapy. 7 All patients in that study were beneficiaries of 1 large statewide medical insurer, having similar copays for medications. No information about the social context of areas of higher or lower adherence was studied.…”

Section: Introductionmentioning

confidence: 99%

Geosocial Factors Associated With Adherence to Statin Medications

2020

Self Cite

View full text Add to dashboard Cite

Background: Individual patient characteristics, social determinants, and geographic access may be associated with patients engaging in appropriate health behaviors. Objective: To assess the relationship between statin adherence, geographic accessibility to pharmacies, and neighborhood sociodemographic characteristics in Michigan. Methods: The proportion of days covered (PDC) was calculated from pharmacy claims of a large insurer of adults who had prescriptions for statins between July 2009 and June 2010. A PDC ≥0.80 was defined as adherent. The predictor of interest was a ZIP code tabulation area (ZCTA)-level measure of geographic accessibility to pharmacies, measured using a method that integrates availability and access into a single index. We fit unadjusted models as well as adjusted models controlling for age, sex, and ZCTA-level measures of socioeconomic status (SES), racial isolation (RI) of non-Hispanic blacks, and urbanicity. Results: More than 174 000 patients’ claims data were analyzed. In adjusted models, pharmacy access was not associated with adherence (0.99; 95% CI: 0.96, 1.03). Greater RI (0.87; 95% CI: 0.85, 0.88) and urban status (0.93; 95% CI: 0.89, 0.96) were associated with lower odds of adherence. Individuals in ZCTAs with higher SES had higher odds of adherence, as were men and older age groups. Conclusion and Relevance: Adherence to statin prescriptions was lower for patients living in areas characterized as being racially segregated or lower income. Initiating interventions to enhance adherence, informed by understanding the social and systematic barriers patients face when refilling medication, is an important public health initiative that pharmacists practicing in these areas may undertake.

show abstract

Section: Introductionmentioning

confidence: 99%

Geosocial Factors Associated With Adherence to Statin Medications

2020

Self Cite

View full text Add to dashboard Cite

show abstract

“…Studies on medication adherence in primary and secondary prevention have investigated association with patient demographic factors, lifestyle and psychosocial factors, geographical location, medication history and physician‐patient communication . In addition, a patient may have different medication adherence before and after events of various types.…”

Section: Introductionmentioning

confidence: 99%

Interrupted time series analysis on first cardiovascular disease hospitalization for adherence to lipid‐lowering therapy

Warren

Exeter

2019

Pharmacoepidemiology and Drug

View full text Add to dashboard Cite

Purpose:We analysed lipid-lowering medication adherence before and after the first hospitalization for cardiovascular disease (CVD) to explore the influence hospitalization has on patient medication adherence. Methods:We extracted a sub-cohort for analysis from 313,207 patients who had primary CVD risk assessment. Adherence was assessed as proportion of days covered (PDC) ≥ 80% based on community dispensing records. Adherence in the 4 quarters (360 days) before the first CVD hospitalization and 8 quarters (720 days) after hospital discharge was assessed for each individual in the sub-cohort. An interrupted time series design using generalized estimating equations was applied to compare the differences of population-level medication adherence rates before and after the first CVD hospitalization. Results: Overall, a significant improvement in medication adherence rate from before to after the hospitalization was observed (odds ratio (OR) 2.49 [1.74-3.57]) among the 946 patients included in the analysis. Patients having diabetes history had a higher OR of adherence before the hospitalization than patients without diabetes (1.50 [1.03-2.22]) but no significant difference after the hospitalization (OR 1.13 [0.89-1.43]). Before the first hospitalization, we observed that quarterly medication adherence rate was steady at around 55% (OR 0.97 [0.93-1.01), whereas the trend in adherence over the post-hospitalization period decreased significantly per quarter (OR 0.97 [0.94-0.99]).Conclusions: Patients were more likely to adhere to lipid-lowering therapy after experiencing a first CVD hospitalization. The change in medication adherence rate is consistent with patients having heightened perception of disease severity following the hospitalization.

show abstract

“…Hot spot analysis is a statistically based method used to identify spatial clusters of high and low values of a phenomenon of interest. Recent studies using this technique have studied geographic variations in medication adherence[ 30 , 31 ], health care spending[ 32 ], locations of over-the-counter (OTC) syringe-selling pharmacies[ 33 ], health disparities in delivery of primary care[ 34 ], availability of healthcare professionals[ 35 ] and locations requiring more Women, Infants, and Children (WIC) program services[ 36 ]. To our knowledge, however, hot spot analysis has not been employed to identify clusters of pharmacy deserts for elderly enrolled in SPAPs.…”

Section: Introductionmentioning

confidence: 99%

Mapping pharmacy deserts and determining accessibility to community pharmacy services for elderly enrolled in a State Pharmaceutical Assistance Program

Pednekar

Peterson

2018

PLoS ONE

View full text Add to dashboard Cite

ObjectivesLimited studies have investigated geographic accessibility to a nearby community pharmacy for elderly which is an essential determinant of the access to medications and pharmacy services. This research identified pharmacy deserts and investigated availability of different types of community pharmacies and their services for elderly enrolled in a State Pharmaceutical Assistance Program (SPAP).MethodsThe state of Pennsylvania in the US was used as a case to demonstrate the geographic accessibility to community pharmacy and services for elderly enrolled in SPAP. The locations of community pharmacies and households of elderly enrolled in SPAP were derived from Pharmaceutical Assistance Contract for the Elderly programs’ database. The street addresses were geocoded and the distance to a nearby community pharmacy was calculated for study sample using the haversine formula. The demographic and geographic data were aggregated to Census Tracts and pharmacy deserts were identified using the predefined criteria. Descriptive statistical analysis was used to determine whether there are statistical differences in the socio-demographic profiles and distribution of different types of community pharmacies and their services in pharmacy deserts and non-deserts. This research used hot spot analyses at county level to identify clusters of pharmacy deserts, areas with high concentration of different racial/ethnic groups and clusters of high densities of chain and independent pharmacies.ResultsThe Spatial analysis revealed that 39% and 61% Census Tracts in Pennsylvania were pharmacy deserts and non-deserts respectively (p < 0.001). Pharmacy deserts were found to have significantly more females, married and white elderly and fewer blacks and Hispanics compared to pharmacy non-deserts. Pharmacy deserts had significantly fewer chain and independent pharmacies and less delivery and 24-hour services in pharmacies than pharmacy non-deserts. Hot spot analyses showed that clusters of pharmacy deserts were more concentrated in southcentral, northwest and northeast regions of the state which represent rural areas and overlapped with clusters of high concentration of white individuals.ConclusionsThe findings suggest that urban-rural inequality, racial/ethnic disparity and differences in availability of pharmacies and their services exist between pharmacy deserts and non-deserts. The methodological approach and analyses used in this study can also be applied to other public health programs to evaluate the coverage and breadth of public health services.

show abstract

Geospatial Analysis of Statin Adherence Using Pharmacy Claims Data in the State of Michigan

Cited by 9 publications

References 46 publications

Geosocial Factors Associated With Adherence to Statin Medications

Geosocial Factors Associated With Adherence to Statin Medications

Interrupted time series analysis on first cardiovascular disease hospitalization for adherence to lipid‐lowering therapy

Mapping pharmacy deserts and determining accessibility to community pharmacy services for elderly enrolled in a State Pharmaceutical Assistance Program

Contact Info

Product

Resources

About