Arthritis & Rheumatism, Volume 62,
November 2010 Abstract Supplement
Abstracts of the American College of
Rheumatology/Association of Rheumatology Health Professionals
Annual Scientific Meeting
Atlanta, Georgia November 6-11, 2010.
An Examination of How Coping with Prescription Medication Costs and Medication Underuse Influences Physical and Mental Health of Individuals with Arthritis.
Remmes Martin, Kathryn, Schoster, Britta, Shreffler, Jack, F. Callahan, Leigh
Our purpose is twofold: 1) to identify the overall frequency and characteristics of individuals who self-report prescription medication cost coping strategies, and 2) to examine the association between coping strategies and medication underuse and physical and mental health outcomes among a cohort of participants with arthritis from a southeastern state.
In 2006 and 2007, 729 people with self-reported physician-diagnosed arthritis completed a telephone survey assessing health status, chronic conditions, neighborhood characteristics, health attitudes and sociodemographic variables. Five health status outcomes used were: Health Assessment Questionnaire (HAQ), disability index; SF-12v2 Physical Component Summary (PCS), physical functioning; SF-12v2 Mental Component Summary (MCS), mental health; Center for Epidemiological Studies-Depression (CES-D) (<16; >=16), depressive symptoms; self-rated health (excellent, very good, & good; fair & poor). Helplessness was also assessed with the Rheumatology Attitudes Index (RAI). Linear and logistic regression analyses using Stata v11 were conducted for each outcome to explore associations with the medication cost coping strategies while adjusting for age, race, gender, body mass index (BMI), co-morbid conditions, and participant education, income, occupation and homeownership.
Participants were on average 61 years old, female (75.0%), non-Hispanic white (76.8%), had a mean BMI of 30.2, and a median income of below $45,000 (55.7%). Overall, participants reported spending less on food, heat, or basic needs (22.4%), borrowing money from a friend or relative outside of their household (16.1%), increased the amount of credit-card debt carried month-to month (11.7%) to pay for medications and taking fewer medications than prescribed due to medication costs (20.2%). Individuals who borrowed money had lower mental health (MCS) (b=-3.87, p=0.003) and greater disability (b=0.14, p=0.044). Individuals increasing credit card debt had worse physical functioning (b=-4.63, p=0.001), and self-rated health (OR =0.43, p=0.005), and reported greater helplessness associated with their condition (b= 0.47, p<0.001). Individuals who reported medication underuse had worse mental health (b=-4.24, p<0.001), greater disability (b=0.13, p=0.028), depressive symptoms (OR=2.03, p=0.004), and a trend for worse self-rated health (OR=0.62, p=0.066). Age, race, BMI, comorbid condition count, education, and income were statistically significant covariates in some of the models dependent on the outcome.
Our findings indicate that individuals with arthritis do use strategies to cope with mediation costs, one of which is medication underuse, and that these strategies have adverse mental and physical health outcomes. Health care practitioners should be alert to issues of medication cost to ensure optimal patient health and medication adherence.
To cite this abstract, please use the following information:
Remmes Martin, Kathryn, Schoster, Britta, Shreffler, Jack, F. Callahan, Leigh; An Examination of How Coping with Prescription Medication Costs and Medication Underuse Influences Physical and Mental Health of Individuals with Arthritis. [abstract]. Arthritis Rheum 2010;62 Suppl 10 :1462