medication adherence trends in north carolina
TRANSCRIPT
About BRFSS Survey◦ Behavioral Risk Factor Surveillance System Survey
Random telephone survey of state residents aged 18 and older in households with telephones
Initially developed in the early 1980s CDC in collaboration with state health departments
Currently conducted in all 50 states, the District of Columbia, and three United States territories
NC has participated since 1987
Interviews are conducted monthly and data are analyzed annually (on a calendar-year basis)
Reported out June of following year
The 2010 NC BRFSS Survey Contained 188 Questions:◦ CDC -Core Sections: Health Status, Healthy Days, Health Care
Access, Sleep, Exercise, Diabetes, Oral Health, Cardiovascular Disease Prevalence, Asthma, Disability, Tobacco Use, Alcohol Consumption, Immunization, Falls, Seatbelt Use, Drinking & Driving, Women's Health, Prostate Cancer Screening, Colorectal Cancer Screening, HIV/AIDS, Emotional Support
◦ CDC -Optional Modules: Pre-Diabetes, General Preparedness
◦ NC -Added Modules: Diabetes Control, Folic Acid, Disability, Prescription Medication Adherence, HPV, Traumatic Brain Injury, Secondhand Smoke, Smoking Cessation, NC Tobacco Use Prevention, TRU Campaign, Quit Now NC, Gambling Behavior, Sexual Behavior, Sexual & Physical Violence
2010 BRFSS – NC Module 7: Prescription Medication Adherence
Overall Adherence Questions:
◦ Has there ever been a time when you have NOT filled or refilled a medication prescribed by a doctor or dentist or other health professional?
◦ How long ago was the last time you did NOT fill or refill medication prescribed by a doctor or other health professional?
Statewide
NC BRFSS 2010
Total Survey Sample
n = 11,273
Overall Prevalence of
Rx Non-Adherence in
Past 12 months
17%
Wake/Durham/Orange
Counties
NC BRFSS 2010
Grouped County
Survey Sample
Overall Prevalence of
Rx Non-Adherence in
Past 12 months
15%
*Age-adjusted, self-reported prevalence
15.1% 13.2% 11.2% 12.0%14.5%
19.3% 18.9%21.7%
25.7%
19.2%
0.0%
10.0%
20.0%
30.0%
40.0%
50.0%
60.0%
70.0%
80.0%
90.0%
100.0%
White Black Other Hispanic Non-Hispanic
Men
Women
Ethnicity
Perc
ent
Overall Non-Adherence Rate* by Gender & Ethnicity
*In the past 12 months
15.7% 11.5%
20.6%16.4%
32.1%
5.7%
27.4%
0.0%
10.0%
20.0%
30.0%
40.0%
50.0%
60.0%
70.0%
80.0%
90.0%
100.0%
Employment Status
Perc
ent
Overall Non-Adherence Rate* by Employment Status
*In the past 12 months
17.1% 17.3%
0.0%
10.0%
20.0%
30.0%
40.0%
50.0%
60.0%
70.0%
80.0%
90.0%
100.0%
Insurance No Insurance
Health Insurance
Perc
ent
Overall Non-Adherence Rate* by Health Insurance Status
*In the past 12 months
21.7%15.4%
0.0%
10.0%
20.0%
30.0%
40.0%
50.0%
60.0%
70.0%
80.0%
90.0%
100.0%
< $25,000 > or = $25,000
Income
Perc
ent
Overall Non-Adherence Rate* by Income
*In the past 12 months
15.0%
23.0%
35.0%39.0%
0.0%
10.0%
20.0%
30.0%
40.0%
50.0%
60.0%
70.0%
80.0%
90.0%
100.0%
0 1 2 3
Number of Conditions
Perc
ent
Overall Non-Adherence Rate* by Number of Conditions
*In the past 12 months Diabetes, Angina/CHD, Asthma
15.0%
28.4%
0.0%
10.0%
20.0%
30.0%
40.0%
50.0%
60.0%
70.0%
80.0%
90.0%
100.0%
Excellent / Very Good / Good Fair / Poor
Health Status
Perc
ent
Overall Non-Adherence Rate* by Perceived Health Status
*In the past 12 months
20.0%
38.3%
0.0%
10.0%
20.0%
30.0%
40.0%
50.0%
60.0%
70.0%
80.0%
90.0%
100.0%
< 14 days > or = 14 days
Limited Activity Days
Perc
ent
Overall Non-Adherence Rate* by Limited Activity Days Due to Poor Health
*In the past 12 months
15.6%
25.0%
15.8%
25.5%
0.0%
10.0%
20.0%
30.0%
40.0%
50.0%
60.0%
70.0%
80.0%
90.0%
100.0%
< 14 days > or = 14 days < 30 days All 30 days
Days Without Rest / Sleep
Perc
ent
Overall Non-Adherence Rate* by Days Without Enough Rest or Sleep
*In the past 12 monthsIn the past 30 days
16.1%
31.6%
0.0%
10.0%
20.0%
30.0%
40.0%
50.0%
60.0%
70.0%
80.0%
90.0%
100.0%
Very Satisfied / Satisfied Very Dissatisfied / Dissatisfied
Life Satisfaction
Perc
ent
Overall Non-Adherence Rate* by Life Satisfaction
*In the past 12 months
16.6%22.9%
0.0%
10.0%
20.0%
30.0%
40.0%
50.0%
60.0%
70.0%
80.0%
90.0%
100.0%
Always / Usually / Sometimes Rarely / Never
Social Support
Perc
ent
Overall Non-Adherence Rate* by Getting Social Support
*In the past 12 months
Reasons for Non-Adherence Questions:◦ I’m going to read a list of reasons people sometime don’t get their
medications filled or refilled. Do any of these reasons apply to you …
You did not get the prescription filled because you did not think the medicine would help
You were concerned about the side effects of the medicine
After taking the medication, it did not seem to help
You could not afford to pay for the medicine
You have refills available but not needed at this time
Some other reason? (open text)
◦ Did your doctor or health professional talk to you about the importance of taking all of your medicine(s)?
44.8%
42.6%
23.1%
35.1%
29.2%
0.0% 5.0% 10.0% 15.0% 20.0% 25.0% 30.0% 35.0% 40.0% 45.0% 50.0%
5
4
3
2
1
Overall Non-Adherence Rate* by Reason
Did not think the medicine would help
Concerned about side effects
Did not seem to help
Could not afford
Refills available, not needed at this time
*In the past 12 months,more than one responseper person allowed
44.8%
42.6%
23.1%
35.1%
29.2%
51.0%
31.0%
23.0%
46.0%
42.0%
0.0% 10.0% 20.0% 30.0% 40.0% 50.0% 60.0%
5
4
3
2
1
Wake-Durham-Orange
Statewide
Overall Non-Adherence Rate* by Reason
Did not think would help
Concerned about side effects
Did not seem to help
Could not afford
Refills available, not needed at this time
*In the past 12 months
Socio-demographic characteristics most associated with adults who did not fill a prescription because they did not think the medicine would help*:
◦ Adults over age 75
◦ Black males – 40.2%
◦ More than a high school education
◦ Employed
◦ Household income greater than or equal to $25,000
◦ Have health insurance
*For adults reporting Rx non-adherence in last 12 months (n=1,768)
Socio-demographic characteristics most associated with adults who did not fill a prescription because they were concerned about side effects*:
◦ Adults over age 75 – 52.6%
◦ Black males
◦ Have health insurance
*For adults reporting Rx non-adherence in last 12 months (n=1,768)
Socio-demographic characteristics most associated with adults who did not fill their prescription because after taking the medicine it did not seem to help*:
◦ Adults 45 – 54 years of age
◦ Males, particularly black males – 34.1%
◦ Less than a high school education
◦ Household income less than $25,000
*For adults reporting Rx non-adherence in last 12 months (n=1,768)
Socio-demographic characteristics most associated with adults who did not fill their prescription because they could not afford to pay for the medication*:
◦ Adults 55-64 years old
◦ Females, particularly black females
◦ Less than a high school education
◦ Unemployed
◦ Household annual income less than $25,000
◦ No health insurance – 78.9%
*For adults reporting Rx non-adherence in last 12 months (n=1,768)
Socio-demographic characteristics most associated with adults who did not fill their prescription even though they had refills available*:
◦ Males, particularly black males – 54.5%
◦ Employed
◦ Household annual income greater than/equal to $25,000
◦ Have insurance
*For adults reporting Rx non-adherence in last 12 months (n=1,768)
Additional Results:
◦ 90.6% of respondents reported that their doctor or health professional spoke with them about the important of taking all medications
◦ Concerns about taking pain medications came up repeatedly in the open comments section of the survey
◦ Being too busy or lazy, forgetting to fill the prescription, or not wanting to take medications in general were also common comments
Next Steps:
◦ Full Report Available on our website
http://www.ncahc.org/ncahc-brfss-adherence-report-2013.html
◦ NCAHC continues to cultivate sponsors for the BRFSS Prescription Medication Adherence Survey going forward
◦ Your thoughts, feedback and input are welcome!
◦ Remember to visit our Resource Centers
Prescription Drug Coverage & Medication Management Resource Center
Medication Adherence & Safety Resource Center
