Socioeconomic Disparities Associated with Medication Non-Adherence Following Lung Transplantation in Adult Recipients

Abstract

Purpose To evaluate the impact of demographic and socioeconomic characteristics on non-adherence (NA) following lung transplantation. Methods and Materials Adult, first time, lung-only transplantations per the United Network for Organ Sharing (UNOS) database were analyzed from 10/1996-12/2006. Generalized linear models were used to determine the association between demographic/socioeconomic characteristics and early ( Results 7,284 patients were included for analysis. Early and late NA were reported in 3.1% and 8.0% of recipients, respectively. Factors associated with early NA were Medicaid insurance status at the time of transplant [adjusted odds ratio (AOR) compared to private insurance 2.19, 95% confidence interval (CI) 1.21 - 3.99, p=0.01], and black ethnicity (AOR compared to white 2.07, CI 1.05 - 4.10, p=0.04). Medicaid insurance and black ethnicity were also associated with an increased risk of late NA (AOR 2.30, CI 1.70 - 3.10, p figure 1 ] Conclusions Data from UNOS suggests that Medicaid insurance status and black ethnicity are associated with increased incidence of NA, which subsequently portends a decrease in post-transplant survival. Targeted interventions to improve medication adherence in this patient population may be warranted.