Unknown

Dataset Information

0

Adherence to Newly Prescribed Diabetes Medications Among Insured Latino and White Patients With Diabetes.


ABSTRACT: Importance:Medication adherence is essential to diabetes care. Patient-physician language barriers may affect medication adherence among Latino individuals. Objective:To determine the association of patient race/ethnicity, preferred language, and physician language concordance with patient adherence to newly prescribed diabetes medications. Design, Setting, and Participants:This observational study was conducted from January 1, 2006, to December 31, 2012, at a large integrated health care delivery system with professional interpreter services. Insured patients with type 2 diabetes, including English-speaking white, English-speaking Latino, or limited English proficiency (LEP) Latino patients with newly prescribed diabetes medication. Exposures:Patient race/ethnicity, preferred language, and physician self-reported Spanish-language fluency. Main Outcomes and Measures:Primary nonadherence (never dispensed), early-stage nonpersistence (dispensed only once), late-stage nonpersistence (received ?2 dispensings, but discontinued within 24 months), and inadequate overall medication adherence (>20% time without sufficient medication supply during 24 months after initial prescription). Results:Participants included 21?878 white patients, 5755 English-speaking Latino patients, and 3205 LEP Latino patients with a total of 46?131 prescriptions for new diabetes medications. Among LEP Latino patients, 50.2% (n?=?1610) had a primary care physician reporting high Spanish fluency. For oral medications, early adherence varied substantially: 1032 LEP Latino patients (32.2%), 1565 English-speaking Latino patients (27.2%), and 4004 white patients (18.3%) were either primary nonadherent or early nonpersistent. Inadequate overall adherence was observed in 1929 LEP Latino patients (60.2%), 2975 English-speaking Latino patients (51.7%), and 8204 white patients (37.5%). For insulin, early-stage nonpersistence was 42.8% among LEP Latino patients (n?=?1372), 34.4% among English-speaking Latino patients (n?=?1980), and 28.5% among white patients (n?=?6235). After adjustment for patient and physician characteristics, LEP Latino patients were more likely to be nonadherent to oral medications and insulin than English-speaking Latino patients (relative risks from 1.11 [95% CI, 1.06-1.15] to 1.17 [95% CI, 1.02-1.34]; P??.28). Conclusions and Relevance:Nonadherence to newly prescribed diabetes medications is substantially greater among Latino than white patients, even among English-speaking Latino patients. Limited English proficiency Latino patients are more likely to be nonadherent than English-speaking Latino patients independent of the Spanish-language fluency of their physicians. Interventions beyond access to interpreters or patient-physician language concordance will be required to improve medication adherence among Latino patients with diabetes.

SUBMITTER: Fernandez A 

PROVIDER: S-EPMC5814298 | biostudies-literature | 2017 Mar

REPOSITORIES: biostudies-literature

altmetric image

Publications

Adherence to Newly Prescribed Diabetes Medications Among Insured Latino and White Patients With Diabetes.

Fernández Alicia A   Quan Judy J   Moffet Howard H   Parker Melissa M MM   Schillinger Dean D   Karter Andrew J AJ  

JAMA internal medicine 20170301 3


<h4>Importance</h4>Medication adherence is essential to diabetes care. Patient-physician language barriers may affect medication adherence among Latino individuals.<h4>Objective</h4>To determine the association of patient race/ethnicity, preferred language, and physician language concordance with patient adherence to newly prescribed diabetes medications.<h4>Design, setting, and participants</h4>This observational study was conducted from January 1, 2006, to December 31, 2012, at a large integra  ...[more]

Similar Datasets

| S-EPMC6292617 | biostudies-literature
| S-EPMC8302254 | biostudies-literature
| S-EPMC6583651 | biostudies-literature
| S-EPMC6980159 | biostudies-literature
| S-EPMC11318347 | biostudies-literature
| S-EPMC4339210 | biostudies-literature
| S-EPMC5920707 | biostudies-literature
| S-EPMC6324353 | biostudies-literature
| S-EPMC8201598 | biostudies-literature