OBJECTIVES: To describe characteristics and trends for emergency department visits related to medication nonadherence and to identify associations between patient characteristics and emergency department visits related to medication nonadherence. DESIGN: Retrospective cross-sectional study. SETTING: National Hospital Ambulatory Medical Care Survey (NHAMCS) from 2005 to 2007. PATIENTS: Patients who had an emergency department visit for medication nonadherence. INTERVENTION: NHAMCS data were weighted to yield national estimates of emergency department visits related to medication nonadherence. Descriptive frequencies were calculated for visits related and unrelated to medication adherence. A binary logistic regression model was used to identify covariates for nonadherence. MAIN OUTCOME MEASURES: National estimates of emergency department visits related to medication nonadherence. RESULTS: An estimated 456,209 ± 68,940 (mean ± SD) nonadherence-related visits occurred. Of visits related to nonadherence, 29% resulted from mental health disorders. Significant covariates of nonadherence-related visits included age, payment source, and primary diagnosis. Visits for patients with mental illness (odds ratio 22.74 [95% CI 14.68-34.20]), type 2 diabetes (15.80 [5.20-48.06]), nondependent abuse of drugs (11.85 [3.83-36.65]), or essential hypertension (11.06 [3.99-30.61]) were significantly associated with the probability that an emergency department visit was related to nonadherence. More than 20% of emergency department visits related to medication nonadherence resulted in hospital admission, whereas only 12.7% of visits unrelated to nonadherence resulted in hospital admission ( P < 0.0001). CONCLUSION: Medication nonadherence is an important problem. Targeting patients at high risk for nonadherence, especially patients with mental illness, may improve medication adherence and prevent future emergency department visits.
OBJECTIVES: To describe characteristics and trends for emergency department visits related to medication nonadherence and to identify associations between patient characteristics and emergency department visits related to medication nonadherence. DESIGN: Retrospective cross-sectional study. SETTING: National Hospital Ambulatory Medical Care Survey (NHAMCS) from 2005 to 2007. PATIENTS: Patients who had an emergency department visit for medication nonadherence. INTERVENTION: NHAMCS data were weighted to yield national estimates of emergency department visits related to medication nonadherence. Descriptive frequencies were calculated for visits related and unrelated to medication adherence. A binary logistic regression model was used to identify covariates for nonadherence. MAIN OUTCOME MEASURES: National estimates of emergency department visits related to medication nonadherence. RESULTS: An estimated 456,209 ± 68,940 (mean ± SD) nonadherence-related visits occurred. Of visits related to nonadherence, 29% resulted from mental health disorders. Significant covariates of nonadherence-related visits included age, payment source, and primary diagnosis. Visits for patients with mental illness (odds ratio 22.74 [95% CI 14.68-34.20]), type 2 diabetes (15.80 [5.20-48.06]), nondependent abuse of drugs (11.85 [3.83-36.65]), or essential hypertension (11.06 [3.99-30.61]) were significantly associated with the probability that an emergency department visit was related to nonadherence. More than 20% of emergency department visits related to medication nonadherence resulted in hospital admission, whereas only 12.7% of visits unrelated to nonadherence resulted in hospital admission ( P < 0.0001). CONCLUSION: Medication nonadherence is an important problem. Targeting patients at high risk for nonadherence, especially patients with mental illness, may improve medication adherence and prevent future emergency department visits.
Authors: Sunita M Desai; Alan Z Chen; Jiejie Wang; Wei-Yi Chung; Jay Stadelman; Chris Mahoney; Adam Szerencsy; Lisa Anzisi; Ateev Mehrotra; Leora I Horwitz Journal: JAMA Intern Med Date: 2022-09-12 Impact factor: 44.409
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