Association of Medication Nonadherence Among Adult Survivors of Stroke After Implementation of the US Affordable Care Act

JAMA Neurology
Deborah A LevineLena M Chen

Abstract

Among adults with chronic disease, survivors of stroke have high out-of-pocket financial burdens. The US government enacted the Affordable Care Act (ACA) in 2010 and implemented the law in 2014 to provide more low-income adults with health insurance coverage. To assess whether ACA implementation is associated with cost-related nonadherence (CRN) to medication among adult survivors of stroke. This study analyzed data from the 2000 to 2016 National Health Interview Survey, an in-person household survey of the noninstitutionalized US population conducted annually by the National Center for Health Statistics. Conducted at the University of Michigan Medical School, Ann Arbor, from July 24, 2017, to February 28, 2018, the study had a sample of 13 930 survivors of stroke. Analyses were stratified by age (45-64 years vs ≥65 years). Time was treated as a continuous variable and as a categorical variable across 4 periods (2000-2005, historical control; 2006-2010, economic recession and peak unemployment; 2011-2013, before ACA implementation; and 2014-2016, after ACA implementation). Percentages are weighted to reflect US population estimates. The primary outcome was the self-report of CRN, defined as the inability to afford prescribed me...Continue Reading

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Citations

Oct 27, 2020·Stroke; a Journal of Cerebral Circulation·Deborah A LevineOlugbenga G Ogedegbe
May 2, 2020·Journal of the American College of Cardiology·Islam Y ElgendyCarl J Pepine
May 2, 2020·Journal of the American College of Cardiology·Xianshi Zhou, Guanghua Tang
Mar 3, 2021·Journal of Advanced Nursing·Gabrielle Harris WalkerJanet Prvu Bettger
Oct 1, 2021·Circulation. Cardiovascular Quality and Outcomes·Blake T McGeeGregg C Fonarow
Dec 17, 2021·Inquiry : a Journal of Medical Care Organization, Provision and Financing·Blake T McGeeWilliam S Custer

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