Key result
Markers of poor medication access, including lack of insurance and difficulty affording medications, were not associated with admission or discharge antihypertensive prescribing costs.
Why the study?
Is insurance coverage or medication access associated with antihypertensive prescribing patterns in patients hospitalized for severe, poorly controlled hypertension?
Cross-Sectional (n=189)
No
Is insurance coverage or medication access associated with antihypertensive prescribing patterns in patients hospitalized for severe, poorly controlled hypertension?
Prescribing patterns for severe hypertension do not appear to be adjusted based on patients' insurance status or ability to afford medications, highlighting a missed opportunity to reduce financial burden by substituting less expensive drugs.
Prescribing costs for severe hypertension were independent of access barriers; leaves open whether cost-conscious adjustments could ease patient burden in future studies.
High medication costs may be a significant cause of nonadherence and threaten recent gains in hypertension treatment. It is unclear whether prescribing patterns differ with patients' insurance coverage. The objective of this study was to determine whether insurance coverage, reported difficulty affording medications, or nonadherence were associated with antihypertensive prescribing in a high-risk population. The authors conducted a cross-sectional survey of 189 patients admitted to an inner-city academic hospital with severe, poorly controlled hypertension. Patients' poor medication access (one-third lacked insurance and half reported difficulty affording medications) was not associated with admission or discharge regimen costs. Substituting the least expensive drug within each class would have reduced costs by 42%, and reducing calcium channel blocker use would have significantly reduced costs. In conclusion, markers of poor medication access were not associated with prescribing patterns. Further research is needed to explore these patterns and their impact on vulnerable populations' financial burden and adherence.
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Dy et al. (2008) conducted a cross-sectional in Severe, poorly controlled hypertension (n=189). Poor medication access (lack of insurance, difficulty affording medications, or nonadherence) vs. Adequate medication access was evaluated on Admission or discharge antihypertensive regimen costs. Markers of poor medication access, including lack of insurance and difficulty affording medications, were not associated with admission or discharge antihypertensive prescribing costs.
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