Financial Strain and Medication Adherence among Diabetes Patients in an Integrated Health Care Delivery System: The Diabetes Study of Northern California (DISTANCE)

Objective To examine self-reported financial strain in relation to pharmacy utilization adherence data. Data Sources/Study Setting Survey, administrative, and electronic medical data from Kaiser Permanente Northern California. Study Design Retrospective cohort design (2006, n = 7,773). Data Collection/Extraction Methods We compared survey self-reports of general and medication-specific financial strain to three adherence outcomes from pharmacy records, specifying adjusted generalized linear regression models. Principal Findings Eight percent and 9 percent reported general and medication-specific financial strain. In adjusted models, general strain was significantly associated with primary nonadherence (RR = 1.37; 95 percent CI: 1.04–1.81) and refilling late (RR = 1.34; 95 percent CI: 1.07–1.66); and medication-specific strain was associated with primary nonadherence (RR = 1.42, 95 percent CI: 1.09–1.84). Conclusions Simple, minimally intrusive questions could be used to identify patients at risk of poor adherence due to financial barriers.