Medication adherence in stroke survivors declines despite Medicare Part D implementation

International Stroke Conference 2011

During the periods of 1998 to 2002 and 2006 to 2009, researchers reported that nonadherence with medication among stroke survivors increased because of cost, particularly among those who were young or uninsured.

Medicare Part D, which went into effect in 2006, was aimed at reducing cost-related medication nonadherence among older adults. Based on the program, adults qualify for Medicare insurance at age 65 while those younger qualify based on disability.

Study investigators determined medication nonadherence due to cost in US stroke survivors from the National Health Interview Survey, a population-based survey that represented the United States. The results were then compared to a previous study on medication nonadherence conducted by the researchers and published in 2007.

What the investigators found was that the proportion of stroke survivors (>45 years of age) who reported medication nonadherence because of cost rose from 8.6% (95% CI, 7.7%-9.7%) between 1998 to 2002 to 11.9% (95% CI, 10.4%-13.7%) from 2006 to 2009. This resulted in a total of 150,000 US stroke survivors reporting medication nonadherence due to cost in 2009. Increases were also reported in younger stroke survivors aged 45-64 years and those uninsured.

Deborah A. Levine, MD, assistant professor of medicine, University of Michigan, Ann Arbor, and trial investigator who presented the findings, told CARDIOLOGY TODAY how these data should impact clinical practice.

“Clinicians need to screen for medication nonadherence due to cost in their patients, particularly in stroke survivors who are younger, uninsured or enrolled in Medicare Part D, and use lower cost medications in those post-stroke patients who need it,” she said.

For more information:

Levine D. Abstract 212. Presented at: International Stroke Conference 2011. Feb. 9-11, 2011; Los Angeles.

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