Skipping Meds May Raise Odds of ER Visits for Certain Medicare Patients

Efforts to reduce drug costs tied to higher risk for disabled recipients

By Mary Elizabeth Dallas

Monday, June 3, 2013

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MONDAY, June 3 (HealthDay News) -- Disabled Medicare patients under 65 who don't take their medications as prescribed because they're too expensive are more likely to end up in the emergency room, according to a new study.
Researchers in Washington, D.C., suggested that emergency rooms may be able to improve medication adherence by implementing policies to help patients access lower-cost drugs or federal and state assistance programs.
The study was published online May 28 in the journal Annals of Emergency Medicine. High non-adherence rates cost an estimated $100 billion a year in preventable hospitalizations, according to a journal news release.
"Poverty and disability increase the risk that patients don't take their medicine because of the cost, which can lead to avoidable hospitalizations," lead study author Dr. Janice Blanchard, of the department of emergency medicine at George Washington University, said in a news release. "As with many other social problems, the emergency department is where these patients end up. It also has the potential to help these patients get their medications affordably so they stay out of the hospital."
The study involved a survey of more than 7,000 Medicare beneficiaries. Of these participants, 7.5 percent reported skipping doses of their medication or trying to make their medication last longer by taking smaller doses or delaying filling their prescriptions. Meanwhile, 8.2 percent reported not filling prescriptions at all because it was too expensive.
Patients who never filled their prescriptions were more likely to have more frequent trips to the emergency room and at least one ER visit within a year. About 38 percent of these patients went to the emergency room, compared with 27.5 percent of patients who took their medication as prescribed.
For disabled Medicare patients, those who never filled their prescriptions were more likely to have at least one emergency room visit than other disabled Medicare patients who took their medicine properly, those who tried to make their medication last longer and older Medicare patients.
"Disabled Medicare patients are a high-risk population," Blanchard said. "Specific policies that aim to help these patients take their medications as needed may be developed in the emergency departments these patients turn to in their hour of need. We may be able to connect them with lower-cost medications or federal and state programs designed to provide prescription assistance."
Although the study suggested that Medicare patients who skip their meds make more frequent ER visits, it did not prove a cause-and-effect relationship.

SOURCE: Annals of Emergency Medicine, news release, May 28, 2013

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