1. Exploring the Relationship Between Medication Adherence and Diabetes Disparities among Hispanic Patients in a Large Health System
- Author
-
Narain, Kimberly Danae Cauley, Patel, Ayan, Skootsky, Samuel, and Mangione, Carol M
- Subjects
Health Services and Systems ,Public Health ,Health Sciences ,Health Disparities ,Behavioral and Social Science ,Clinical Research ,Health Services ,Minority Health ,Diabetes ,Management of diseases and conditions ,7.1 Individual care needs ,Humans ,Medication Adherence ,Male ,Female ,Middle Aged ,Hispanic or Latino ,Adult ,Cross-Sectional Studies ,Aged ,Diabetes Mellitus ,Hypoglycemic Agents ,Glycated Hemoglobin ,California ,Young Adult ,Adolescent ,Healthcare Disparities ,diabetes ,disparities ,medication adherence ,Hispanics ,Clinical Sciences ,General & Internal Medicine ,Clinical sciences ,Health services and systems ,Public health - Abstract
BackgroundSub-optimal HbA1c control is a driver of disparities in diabetes outcomes among Hispanic patients. Differences in medication adherence may underlie racial/ethnic differences in HbA1c level.ObjectiveTo examine the relationship between medication adherence and disparities in HbA1c level among Hispanic patients, relative to other racial/ethnic groups, obtaining care in the University of California Health System (UC Health).DesignThis study used clinical, administrative, and prescription dispensing data (January-December 2021) derived from the electronic health records of 5 Academic Medical Centers in UC Health, and linear regression models (LRMs) to conduct a cross-sectional analysis of the association between medication adherence, race/ethnicity, and HbA1c level. Adjusted LRMs were run with and without the measure of medication adherence to assess this relationship.ParticipantsPatients with a UC Health primary care physician (PCP), with ≥ 1 PCP visit within the last 3 years, ages 18-75, reporting Asian, Hispanic, or White race/ethnicity, and who had ≥ 2 encounters with an ICD diagnosis of diabetes or had a prescription for a diabetes medication within the last 2 years, as of 12/31/21 (N = 27, 542; Asian = 6253, Hispanic = 7216, White = 14,073).Main measuresOur measure of medication adherence was the proportion of days covered (PDC) for diabetes medications in 2021. Our outcome was the most recent HbA1c value.Key resultsIn the LRM excluding the PDC, Hispanic ethnicity was positively associated with HbA1c level (β = 0.31, p =
- Published
- 2024