Non-Adherence Has Been Shown to Lead to Cardiovascular Disease and Even Death
Newswise — A new study published online this month in the Journal of Urban Health conducted by researchers in the Department of Population Health at NYU Langone Medical Center, the New York City Department of Health and Mental Hygiene, and the New York State Department of Health found only 63 percent of New Yorkers on Medicaid with chronic conditions including hypertension, diabetes and high cholesterol are adherent to medication regimens. Non-adherence to medications is associated with higher costs of care, increased hospitalizations and even death.
The study was designed to determine rates of adherence among participants enrolled in New York City Medicaid with chronic conditions most at risk for cardiovascular disease. The retrospective analysis included more than 150,000 Medicaid patients aged 20 to 64 years old and showed older patients and white patients had the greatest adherence. Black patients and Hispanic patients had the lowest adherence rates, according to the study, while adherence among Asians was similar to whites.
“The outcome of this study is concerning as it shows a large number of people with chronic conditions that lead to cardiovascular disease aren’t taking prescribed medications, which could prevent a potential stroke or heart attack,” said lead author Kelly Kyanko, MD, MHS, an instructor in the Department of Population Health and principal investigator of the study. “We hope these findings will help local health authorities in the New York City area address this problem by creating programs to increase adherence rates, specifically in patient populations most at risk.”
Cardiovascular disease is the leading cause of death in the United States and in New York State. Having chronic conditions like hypertension, diabetes and high cholesterol can cause cardiovascular disease if left untreated, which can lead to atherosclerosis and major cardiovascular events, including heart attack and stroke. A quarter of New Yorkers have high blood pressure and 12 percent of the city’s population has diabetes. “Many people do not even know they have these diseases,” Kyanko said.
The study was performed using the 2008-2009 New York State Department of Health’s Medicaid claims database of New York City residents. Those included in the study were continually enrolled in Medicaid for 15 months and suffered from hypertension, diabetes and/or high cholesterol and filled at least one prescription for a chronic condition since they enrolled in the program.
“We believe that patients and their doctors can work to improve medication adherence through simple measures such as switching to once-a-day or combination pills, keeping a pill box, and obtaining 90 day refills instead of 30 day refills for medications they take on a regular basis,” said Dr. Kyanko. She noted that for high risk patients, more intensive interventions such as working with a nurse or pharmacist may be needed to ensure adherence.
Co-authors of the study include Sonia Y. Angell, MD, MPH, Centers for Disease Control and Prevention (formerly at the New York City Department of Health and Mental Hygiene) and Robert H. Franklin, New York State Department of Health.
For more information, please visit the Department of Population Health at NYU Langone Medical Center.
About NYU Langone Medical CenterNYU Langone Medical Center, a world-class, patient-centered, integrated, academic medical center, is one on the nation’s premier centers for excellence in clinical care, biomedical research and medical education. Located in the heart of Manhattan, NYU Langone is composed of four hospitals – Tisch Hospital, its flagship acute care facility; the Hospital for Joint Diseases, one of only five hospitals in the nation dedicated to orthopaedics and rheumatology; Hassenfeld Pediatric Center, a comprehensive pediatric hospital supporting a full array of children’s health services; and the Rusk Institute of Rehabilitation Medicine, the world’s first university-affiliated facility devoted entirely to rehabilitation medicine– plus NYU School of Medicine, which since 1841 has trained thousands of physicians and scientists who have helped to shape the course of medical history. The medical center’s tri-fold mission to serve, teach and discover is achieved 365 days a year through the seamless integration of a culture devoted to excellence in patient care, education and research. For more information, go to www.NYULMC.org.
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