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Gender, race impact adherence, CVS-led study shows
May 14th, 2013
WOONSOCKET, R.I. – CVS Caremark-led research found that among those using statin drugs for cardiovascular disease, nonwhite patients were 50% more likely not to adhere to their medication than white patients, and women were 10% more likely to be nonadherent than men.
CVS said Tuesday that the findings provide valuable insight into the influence of gender and race on medication adherence for statins used to treat high cholesterol. The study was conducted by researchers at CVS Caremark and Brigham and Women's Hospital and published in the May issue of The American Heart Journal.
"While it has long been known that sociodemographic characteristics are associated with nonadherence, this study is the first of its kind to look at the scale and scope of this association," Troy Brennan, executive vice president and chief medical officer at CVS Caremark, said in a statement. "This research helps those of us in the health care field better understand how to improve our outreach to patients who may be at a higher risk of nonadherence and develop programs to help these patients improve their medication adherence."
Including more than 1.7 million patients, the study involved a review of more than 50 publications focused on gender and racial disparities related to medication adherence. The finding that nonadherence was higher based on a patient's gender or race held true even in studies that adjusted for income, insurance status, co-payment amounts and other factors that could contribute to non-adherence, the researchers noted.
In addition, they cited a number of possible reasons for nonadherence among women and nonwhite patients. For example, active prevention of heart disease may not be a priority for women and their health care providers because of the common misconception that women are less at risk than men. Women also often serve as informal caregivers for family members and may be further impacted by the fact that caregivers frequently have lower rates of medication adherence.
Meanwhile, nonwhite patients are less likely to have a consistent relationship with a primary care provider than white patients, which can impact chronic care and adherence, the researchers explained. Also, both women and various racial and ethnic minorities may be more likely to experience side effects from statins, a commonly cited reason for early discontinuation or poor adherence.
"These findings help us better understand the impact of certain demographic factors on medication adherence," stated Niteesh Choudhry, associate physician for the division of pharmacoepidemiology and pharmacoeconomics at Brigham and Women's Hospital and associate professor at Harvard Medical School. "Since a large number of patients depend on medication therapy for primary and secondary prevention of cardiovascular disease, we believe that efforts to reduce nonadherence for statins can have a significant effect on addressing health care disparities, improving health outcomes and ultimately reducing costs."
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