Predicting Adherence to Prescription Medication Purchase Among HMO Enrollees With Diabetes

OBJECTIVE: To identify variables that determine the likelihood those enrollees with diabetes in a health maintenance organization (HMO) will adhere to purchasing prescription medications. METHODOLOGY: A survey was mailed to 200 diabetic patients aged 18-64 who were enrolled in a metropolitan HMO during 1995. RESULTS: Psychosocial barriers, susceptibility to complications, and patients' experiences in hospitalization or emergency room visits were found to be the most significant predictors of adherence. Lower adherence to medication purchase was found among patients who perceived significant barriers to obtaining and using medication, and among patients who had been hospitalized or treated in an emergency room for diabetic complications. Patients who perceived themselves at greater risk for complications related to diabetes were more likely to adhere to prescription medication purchases. Drug cost sharing also demonstrated significant influence on patient behavior. CONCLUSIONS: Overall findings suggest that managed care organizations can contain their diabetic medical expenses through proper policy formulation and increased patient... education.