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GUIDELINES/RECOMMENDATIONS How are older adults with atrial fibrillation adapting to the rising costs of medication, and what factors influence their cost-reducing behaviors?
In the face of escalating medication prices in the United States, older adults, particularly those with atrial fibrillation (AF), are increasingly engaging in cost-reducing behaviors (CRBs). The SAGE-AF study delves into the patterns of CRB, cost-related medication nonadherence, and the compromises made on basic needs to afford medications. This study also examines the characteristics of participants that are associated with CRB, shedding light on a critical aspect of healthcare management for older adults.
Study Design:
- Participants: 1,224 older adults (mean age 76, 49% female) with AF and high stroke risk (CHA2DS2VASc ≥ 2).
- Methods: Prospective cohort study evaluating CRB, cost-related medication nonadherence, and spending less on basic needs using validated measures. Statistical tests were used to examine factors associated with CRB.
Key Findings:
- CRB Engagement: 69% reported engaging in CRB.
- Cost-related Nonadherence: 4% reported nonadherence due to costs.
- Spending Less on Basic Needs: 6% reported compromises on basic needs.
- Factors Influencing CRB: Cognitive impairment and non-Hispanic white identity were associated with lower CRB engagement, while being married, having a household income of $20,000-$49,999, Medicare insurance, and 4-6 comorbidities were associated with higher CRB engagement.
Conclusion:
- CRBs are prevalent among older adults with AF, but few reported cost-related medication nonadherence and spending less on basic needs.
- Targeted support, especially for patients with cognitive impairment, may enhance CRB management and patient assistance programs.
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Did You Know?
Seven out of 10 older adults with atrial fibrillation report engaging in cost-reducing behaviors such as asking for generic medications and purchasing prescriptions online.