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Copyright (c) 2004
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Seniors not taking medications as directed
more likely to face long-term health problems


Kaiser Family Foundation
Friday, June 25, 2004

Senior citizens who did not follow their prescribed drug regimens because they could not cover the costs were 76% more likely in the long run to have an overall "major decline in health" than elderly patients who followed their doctors' orders, according to a study published Friday in Medical Care, a journal of the American Public Health Association, Scripps Howard/Arkansas Democrat-Gazette reports. The study, funded by the National Institute on Aging, is the first to record "the extent of harm that occurs over time from restricting such regimens due to cost," Scripps Howard/Democrat-Gazette reports. In the three-year study, lead author Dr. Michele Heisler, a researcher from the VA Ann Arbor Healthcare System, and colleagues from the University of Michigan Medical School's Institute for Social Research surveyed 8,000 older adults. Participants initially were questioned in 1992, again in 1995 or 1996 and a final time in 1999. The participants were separated into one group of people between the ages of 51 and 61 at the beginning of the survey and another group of people who were at least 70 when the study began.

Findings At the start of the study, there were "no significant differences" between the medical records of those who did and did not take medications for heart disease, diabetes, high blood pressure or strokes, Scripps Howard/Democrat-Gazette reports. However, by the end of the study, 11.9% of people who did not comply with their recommended prescription drug regimens had been affected by chest pain, compared with 8.2% of those who took their medications as directed. The study also found that 7.3% of patients who limited drugs had a nonfatal heart attack or stroke, compared with 5.3% of the compliant group. Overall, patients who did not adhere to their course of medication therapy were 50% more likely to have a heart attack, stroke or chest-pain episode and 76% more likely to be affected by a major decline in total health than those who took their recommended medications as directed.

Specific Conditions The study also found that people who were older than 70 and had depression experienced a "significant worsening" of depression if they cut back on their medicine, Scripps Howard/Democrat-Gazette reports. However, the study found no significant differences between people who restricted or stayed on their prescribed drugs for the onset or worsening of diabetes or arthritis. Heisler said that it might take more time for the long-term effect of decreased prescription drugs for those conditions to become apparent. Heisler said, "A lot of critics are saying it's too expensive to provide or improve drug coverage, but studies like this show that the downstream costs from adverse health outcomes later may be more expensive" (Bowman, Scripps Howard/Arkansas Democrat-Gazette, 6/25).
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Centers for Medicare and Medicaid Services: http://www.medicare.gov/AssistancePrograms/

House Democrats' drug price comparison: http://www.house.gov/reform/min/
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