Removing cost barriers not complete answer for medication adherence
medwireNews: Offering free medications to patients who struggle to afford them improves adherence, but with mixed effects on surrogate disease outcomes, report the CLEAN Meds researchers.
During 12 months of the randomized trial, 38.2% of 395 patients receiving free medications for diabetes, hypertension, or dyslipidemia took at least 80% of their prescribed doses, judged from frequency of prescription refills and self-report.
This was a significant 11.6% absolute increase over the 26.6% adherence rate observed in the 391 patients in the control group, who continued to pay full or partial prescription charges depending on their medical insurance status.
Glycated hemoglobin rates among those with diabetes improved from 8.20% to 7.69% in the free medications group and from 8.15% to 8.04% in the control group, equating to a 0.38% absolute difference that did not quite attain statistical significance.
However, Navindra Persaud (University of Toronto, Ontario, Canada) and co-researchers note that this difference “if true, may be enough to reduce microvascular complications, based on trials of intensive control.”
There was also a significant 7.2 mmHg difference in systolic blood pressure, in favor of the free medications group, but no difference in low-density lipoprotein cholesterol levels, reports the team in JAMA Internal Medicine.
These findings highlight “that cost is only one of several contributors to nonadherence and that medicines are just one part of care,” they conclude.
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