PDB29 Medication Non-Adherence and Health Literacy Among Medicare Beneficiaries with Type 2 Diabetes

Abstract

Medication non-adherence can lead to poor glycemic control and worsen health outcomes for individuals with diabetes. Evidence on the impact of health literacy on medication non-adherence is sparse. We examined the relationship between health literacy and medication non-adherence among Medicare beneficiaries with type 2 diabetes. We analyzed the 2018 Medicare Current Beneficiary Survey Public Use File, a nationally representative sample comprised of Medicare beneficiaries aged ≥ 65 years with reported type 2 diabetes (n=919). Medication non-adherence (outcome variable) was constructed as binary, and three main independent variables were recoded and created as follows: (1) whether the Medicare prescription drug benefit was easy/difficult to understand (binary); (2) whether providers gave instructions on how to take care of one’s health (binary); and (3) whether providers provided medication-related information (categorical). The third variable contained 4 categories and measured whether medical providers talked with beneficiaries about how to take medication and what to do with adverse reactions. A survey-weighted logistic model, adjusted for socio-demographics and co-morbidities, was performed to examine associations between medication non-adherence and the three variables. Approximately 19.6% (n=150) of Medicare beneficiaries reported medication non-adherence. Beneficiaries who reported they easily understood the prescription drug benefit were less likely to report non-adherence, compared to their counterparts (odds ratio (OR)=0.31, p<0.001). Beneficiaries who reported providers gave instructions on how to take care of one’s health were not significantly associated with medication non-adherence. Beneficiaries who reported providers talked to them about how to take medication and what to do with adverse reactions were less likely to report medication non-adherence, compared to those who reported providers did not talk about both information (OR=0.46, p=0.028). Improved comprehension of medication literacy may improve medication non-adherence among Medicare beneficiaries with type 2 diabetes. Healthcare providers could play a critical role in helping this at-risk population.