Abstract P210: Blood Pressure Medication Adherence Among Medicare Beneficiaries, Causes and Consequences

Abstract

Introduction: Medication non-adherence is a major healthcare barrier, especially among diseases which are largely asymptomatic such as hypertension. The impact of poor medication adherence ranges from patient specific adverse health outcomes to broader strains on health care system resources. Accordingly, there is rich literature examining the causes and consequences of suboptimal medication adherence. Objective: To document the relationship between blood pressure medication adherence, socioeconomic status, health care costs, and outcomes among Medicare beneficiaries with heart disease in the United States. Methods: The CDC Wonder database was used to retrieve Centers for Medicare and Medicaid Services’ data pertaining to blood pressure medication adherence, socio-economic variables, per-capita healthcare costs, and cardiovascular outcomes among beneficiaries by county across the United States. Spearman correlation was used to analyze the relationship between various factors. Results: Among Medicare beneficiaries, blood pressure medication non-adherence rates ranged from 15.9% to 56.2% with a mean of 26.5% ± 5.3% among the 3,196 counties reporting data. Factors that strongly correlated with non-adherence include poor educational attainment (0.678, p&lt0.01) and poverty status (0.613, p&lt0.01). Although non-adherence had a weakly positive relationship with inpatient costs (0.183, p&lt0.01) and total overall costs (0.324, p&lt0.01), it demonstrated a solid correlation with cardiovascular deaths (0.42, p&lt0.01), stroke death (0.420, p&lt0.01), stroke hospitalization (0.415, p&lt0.01), and hypertension related hospitalization (0.561, p&lt0.01). Conclusions: Our analysis of Medicare beneficiary data across the United States demonstrates a strong correlation between socioeconomic determinants of health and poor medication adherence. Our data further demonstrates that poor medication adherence translates into both worse cardiovascular outcomes and higher health care costs. In an era where health care spending has become overwhelmingly problematic, these findings provide compelling evidence for increased efforts focusing on educational and incentive based programs to improve medication adherence.