PMID: 12752842May 20, 2003Paper

Income-related differences in the use of evidence-based therapies in older persons with diabetes mellitus in for-profit managed care

Journal of the American Geriatrics Society
Arleen F BrownCarol M Mangione

Abstract

To determine whether income influences evidence-based medication use by older persons with diabetes mellitus in managed care who have the same prescription drug benefit. Observational cohort design with telephone interviews and clinical examinations. Managed care provider groups that contract with one large network-model health plan in Los Angeles County. A random sample of community-dwelling Medicare beneficiaries with diabetes mellitus aged 65 and older covered by the same pharmacy benefit. Patients reported their sociodemographic and clinical characteristics. Annual household income (> or =$20,000 or <$20,000) was the primary predictor. The outcome variable was use of evidence-based therapies determined by a review of all current medications brought to the clinical examination. The medications studied included use of any cholesterol-lowering medications, use of 3-hydroxy-3-methylglutaryl coenzyme A reductase inhibitors (statins) for cholesterol lowering, aspirin for primary and secondary prevention of cardiovascular disease, and angiotensin-converting enzyme (ACE) inhibitors in those with diabetic nephropathy. The influence of income on evidence-based medication use was adjusted for other patient characteristics. The cohort ...Continue Reading

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