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Medication Costs as a Primary Cause of Nonadherence in the Elderly

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Many elderly enrolling in the Medicare Part D prescription drug benefit, which began January 1, 2006, have low annual incomes and few countable assets. Although some are eligible for special assistance to pay for prescription medications, many others will still have significant out-of-pocket expenses while enrolled. The inability to pay for medications is an important cause of nonadherence in the elderly and has been associated with an increase in adverse drug events, acute hospitalizations, and nursing home admissions. This case describes a 77-year-old woman residing in a retirement community who was failing to respond to drug therapy for her hypertension and diabetes. The physician was unaware of her inability to pay for medications, and the patient was too embarrassed to discuss the issue. The case demonstrates some of the techniques that a pharmacist can use to adjust a patient's medication regimen to reduce the cost load, improve adherence, and maintain treatment goals.

Keywords: Case study; Cost; Diabetes mellitus; Medications; Nonadherence

Document Type: Research Article

Publication date: February 1, 2006

More about this publication?
  • The Consultant Pharmacist® is the official peer-reviewed journal of the American Society of Consultant Pharmacists. It is dedicated exclusively to the medication needs of the elderly in all settings, including adult day care, ambulatory care, assisted living, community, hospice, and nursing facilities. This award-winning journal is a member benefit of ASCP. Individuals who are not members and wish to receive The Consultant Pharmacist® will want to consider joining ASCP.
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