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Four in 10 Senior Citizens Not Taking Prescribed
Medications
Survey of nearly 18,000 seniors nationally shows
coverage varies across states; Cost, lack of confidence cited
April 19, 2005 – A massive survey released today
says four in 10 seniors say that they haven't taken all the drugs their
doctors prescribed for them in the past year -- either because the costs
were too high, because they didn't think the drugs were helping them, or
because they didn't think they needed them. Aug. 1, 2002 - A survey of
seniors in August of 2002 found nearly one quarter of seniors report
skipping doses of medicine or not filling prescriptions because of
costs.
The new survey of 17,685 seniors and the 2002 study
were conducted by the Kaiser Family Foundation, the Commonwealth Fund
and Tufts-New England Medical Center.
The survey reveals that many seniors deal with
complex and costly drug regimens. Of the 89% of seniors who report
taking prescription drugs in the past year, nearly half (46%) take five
or more, more than half (54%) have more than one doctor who prescribes
medicine, and about a third (35%) use more than one pharmacy. Among
seniors with at least three chronic health conditions, nearly three of
four (73%) take five or more medications regularly and more than half
(52%) do not take all their drugs as prescribed.
"With two out of five seniors not taking medicines
as prescribed, there is a real opportunity to improve patient care both
by urging doctors and patients to talk more about these issues and by
developing systems to monitor quality and safety," said Commonwealth
Fund President Karen Davis, Ph.D. "These steps are an important
complement to the new Medicare prescription drug coverage."
"The substantial variations in drug coverage across
states documented in this survey suggest that targeted outreach efforts
have the best chance of reaching seniors," said Kaiser Family Foundation
President Drew E. Altman, Ph.D.
An article published online today by the journal
Health Affairs features results from the 2003 national survey of
Medicare beneficiaries 65 and older. The survey was conducted prior to
the enactment of the Medicare Modernization Act and included a
representative national sample with oversampling from 12 states --
California, Colorado, Florida, Illinois, Louisiana, Michigan, New York,
Ohio, Pennsylvania, Texas, Tennessee and Washington. Dana Gelb Safran,
Sc.D., who directs The Health Institute at Tufts-New England Medical
Center, led the research team.
Nationally, slightly more than one in four seniors
(27%) reported that they did not have any prescription drug coverage at
the time of the survey. Coverage rates varied widely across states, with
seniors in Louisiana (35%) and Washington (36%) more than twice as
likely to lack coverage than seniors in New York (16%). Among low-income
seniors (those with incomes less than twice the federal poverty level)
nationwide, one-third lacked coverage -- and in several states,
including Ohio, Louisiana, Texas and Washington, more than 40% of
low-income seniors lacked coverage.
"Drug costs have been a major concern for seniors.
The new Medicare drug benefit, coupled with the low-income subsidies,
presents a real opportunity to get seniors the help they need," Dr.
Safran said. "The challenge will be getting seniors the information they
need to make good enrollment decisions and ensuring that low-income
seniors take advantage of the subsidies available to them."
Seniors were about as likely to cite their
experiences with their medications as a reason for not taking their
medications as prescribed as they were to cite the cost of their drugs,
with 25% saying they skipped doses or stopped taking a drug because it
made them feel worse or wasn't helping, and 26% saying that they did not
fill a prescription, skipped doses or took smaller doses due to cost
reasons.
Drug coverage made a substantial difference in
adherence rates, with 37% of seniors without drug coverage reporting
cost-related non-adherence, compared with 22% of seniors with drug
coverage. Low-income seniors without drug coverage generally took fewer
drugs than those with drug coverage.
Seniors also reported wide differences in the
source of their drug coverage across states. For example, nationally 29%
of seniors reported having employer-sponsored drug coverage, but state
rates for employer-sponsored drug coverage ranged from 24% in Washington
to 47% in Michigan.
The survey also asked about obtaining drugs from
other countries. Overall, one in 20 seniors (5%) reported having
obtaining prescription drugs from pharmacies in Canada or Mexico. These
rates varied across the 12 states, from a high of 11% in Washington to a
low of 2 % in New York. Seniors without drug coverage were more likely
to obtain drugs from Canada or Mexico. Nationally 11% of seniors without
drug coverage reported obtaining from one of those nations, with the
state levels ranging from 19% in Colorado to 5% in Tennessee.
Today's article, Prescription Drug Coverage and
Seniors: Findings from a 2003 National Survey, and several additional
exhibits, including state-specific data, are available at
http://www.kff.org/medicare/med041905pkg.cfm and www.cmwf.org .
METHODOLOGY
National Survey of Seniors and Prescription Drugs,
2003 was designed and analyzed by researchers at the Kaiser Family
Foundation, The Commonwealth Fund, and Tufts -- New England Medical
Center. The research team included Dana Safran, Ira Wilson, Angela Li,
Hong Chang, and William Rogers of the Tufts-New England Medical Center;
Tricia Neuman and Michelle Kitchman of the Kaiser Family Foundation; and
Cathy Schoen and Barbara Cooper (formerly) of the Commonwealth Fund.
The survey was administered in English and Spanish
between July 15 and October 7, 2003, primarily by mail with telephone
follow-up. A randomly selected nationally representative sample of
36,901 non-institutionalized Medicare beneficiaries ages 65 and older
were drawn for the study, including approximately 2,200 from each of 12
states targeted for oversampling to be able to make cross-state
comparisons. After accounting for beneficiaries excluded because of
death, institutionalizations, relocation, non-English/Spanish language,
or severe cognitive or physical impairment, the final study sample
captures the experiences of 17,685 non-institutionalized seniors on
Medicare. The survey has a margin of sampling error of less than 1% for
national percentages, less than 2% for state-specific statistics, and
less than 3% for state-specific, low-income statistics.
The Kaiser Family Foundation is a non-profit,
private operating foundation dedicated to providing information and
analysis on health care issues to policymakers, the media, the health
care community, and the general public. The Foundation is not associated
with Kaiser Permanente or Kaiser Industries.
The Commonwealth Fund is a private foundation that
supports independent research on health and social issues and makes
grants to improve health care practice and policy.
Tufts-New England Medical Center is a world-class,
academic medical institution that is home to both a full-service
hospital for adults and the Floating Hospital for Children. It serves as
the primary clinical and teaching affiliate of Tufts University School
of Medicine.
Source: Henry J. Kaiser Family Foundation
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