Associations between joblessness and oral anti-diabetic medication adherence in US diabetic working-age adults

Mary Lynn Davis-Ajami, Milap C. Nahata, Gregory Reardon, Eric E. Seiber, Rajesh Balkrishnan

Research output: Contribution to journalArticle

4 Citations (Scopus)

Abstract

OBJECTIVE: To assess potential associations between joblessness and oral anti-diabetic (OAD) medication adherence in US diabetic working-age adults. STUDY DESIGN: A retrospective longitudinal panel design used pooled 2001-2007 Medical Expenditure Panel Survey (MEPS) data forming a nationally representative sample of diabetic individuals, ages 24-59 years. Pregnancy, seasonal job status, retired persons, a student designation, and those prescribed insulin were excluded. Adherence was measured using the proportion of days covered (PDC). A PDC $0.80 was classified as adherent. Descriptive statistics and multivariate regression analysis accounting for the MEPS' complex survey design were conducted. RESULTS: There were 2256 individuals (means: age 48.3 years [SD 8.15], body mass index 31.1 [SD 0.30], Charlson Comorbidity Index 0.37 [SD 0.79]) who met study criteria. Thirty-four percent were jobless at the first interview round and 29% remained jobless all 5 interview rounds during the 2-year panel period. Reasons cited for joblessness included: waiting to start a new job (73%) and unable to work due to illness or disability (20%). Negligible proportions cited staying home to care for family members or maternity leave as reasons for joblessness. Proportionately, more individuals were nonadherent (55%, SE 0.006). Joblessness was associated with a 16% significant reduction in the PDC (β -15.9, P < 0.001), and a 25% less likelihood of OAD medication adherence compared with those employed (odds ratio 0.75; 95% confidence interval, 0.64-0.90, P = 0.002), while holding all other variables constant. CONCLUSIONS: The results indicate that jobless working-age individuals with diabetes were significantly less likely to adhere to OAD medication than employed individuals.

Original languageEnglish (US)
JournalHealth Outcomes Research in Medicine
Volume3
Issue number3
DOIs
StatePublished - Jan 1 2012
Externally publishedYes

Fingerprint

Medication Adherence
Health Expenditures
Family Leave
Parental Leave
Interviews
Home Care Services
Comorbidity
Body Mass Index
Multivariate Analysis
Odds Ratio
Regression Analysis
Confidence Intervals
Insulin
Students
Pregnancy
Surveys and Questionnaires

Keywords

  • Diabetes
  • Employment
  • Job status
  • Joblessness
  • Medication adherence
  • Medication use

ASJC Scopus subject areas

  • Health Policy

Cite this

Associations between joblessness and oral anti-diabetic medication adherence in US diabetic working-age adults. / Davis-Ajami, Mary Lynn; Nahata, Milap C.; Reardon, Gregory; Seiber, Eric E.; Balkrishnan, Rajesh.

In: Health Outcomes Research in Medicine, Vol. 3, No. 3, 01.01.2012.

Research output: Contribution to journalArticle

@article{4a601de60d06409e9d1c5febcac399d9,
title = "Associations between joblessness and oral anti-diabetic medication adherence in US diabetic working-age adults",
abstract = "OBJECTIVE: To assess potential associations between joblessness and oral anti-diabetic (OAD) medication adherence in US diabetic working-age adults. STUDY DESIGN: A retrospective longitudinal panel design used pooled 2001-2007 Medical Expenditure Panel Survey (MEPS) data forming a nationally representative sample of diabetic individuals, ages 24-59 years. Pregnancy, seasonal job status, retired persons, a student designation, and those prescribed insulin were excluded. Adherence was measured using the proportion of days covered (PDC). A PDC $0.80 was classified as adherent. Descriptive statistics and multivariate regression analysis accounting for the MEPS' complex survey design were conducted. RESULTS: There were 2256 individuals (means: age 48.3 years [SD 8.15], body mass index 31.1 [SD 0.30], Charlson Comorbidity Index 0.37 [SD 0.79]) who met study criteria. Thirty-four percent were jobless at the first interview round and 29{\%} remained jobless all 5 interview rounds during the 2-year panel period. Reasons cited for joblessness included: waiting to start a new job (73{\%}) and unable to work due to illness or disability (20{\%}). Negligible proportions cited staying home to care for family members or maternity leave as reasons for joblessness. Proportionately, more individuals were nonadherent (55{\%}, SE 0.006). Joblessness was associated with a 16{\%} significant reduction in the PDC (β -15.9, P < 0.001), and a 25{\%} less likelihood of OAD medication adherence compared with those employed (odds ratio 0.75; 95{\%} confidence interval, 0.64-0.90, P = 0.002), while holding all other variables constant. CONCLUSIONS: The results indicate that jobless working-age individuals with diabetes were significantly less likely to adhere to OAD medication than employed individuals.",
keywords = "Diabetes, Employment, Job status, Joblessness, Medication adherence, Medication use",
author = "Davis-Ajami, {Mary Lynn} and Nahata, {Milap C.} and Gregory Reardon and Seiber, {Eric E.} and Rajesh Balkrishnan",
year = "2012",
month = "1",
day = "1",
doi = "10.1016/j.ehrm.2012.06.001",
language = "English (US)",
volume = "3",
journal = "Health Outcomes Research in Medicine",
issn = "1877-1319",
publisher = "Elsevier Inc.",
number = "3",

}

TY - JOUR

T1 - Associations between joblessness and oral anti-diabetic medication adherence in US diabetic working-age adults

AU - Davis-Ajami, Mary Lynn

AU - Nahata, Milap C.

AU - Reardon, Gregory

AU - Seiber, Eric E.

AU - Balkrishnan, Rajesh

PY - 2012/1/1

Y1 - 2012/1/1

N2 - OBJECTIVE: To assess potential associations between joblessness and oral anti-diabetic (OAD) medication adherence in US diabetic working-age adults. STUDY DESIGN: A retrospective longitudinal panel design used pooled 2001-2007 Medical Expenditure Panel Survey (MEPS) data forming a nationally representative sample of diabetic individuals, ages 24-59 years. Pregnancy, seasonal job status, retired persons, a student designation, and those prescribed insulin were excluded. Adherence was measured using the proportion of days covered (PDC). A PDC $0.80 was classified as adherent. Descriptive statistics and multivariate regression analysis accounting for the MEPS' complex survey design were conducted. RESULTS: There were 2256 individuals (means: age 48.3 years [SD 8.15], body mass index 31.1 [SD 0.30], Charlson Comorbidity Index 0.37 [SD 0.79]) who met study criteria. Thirty-four percent were jobless at the first interview round and 29% remained jobless all 5 interview rounds during the 2-year panel period. Reasons cited for joblessness included: waiting to start a new job (73%) and unable to work due to illness or disability (20%). Negligible proportions cited staying home to care for family members or maternity leave as reasons for joblessness. Proportionately, more individuals were nonadherent (55%, SE 0.006). Joblessness was associated with a 16% significant reduction in the PDC (β -15.9, P < 0.001), and a 25% less likelihood of OAD medication adherence compared with those employed (odds ratio 0.75; 95% confidence interval, 0.64-0.90, P = 0.002), while holding all other variables constant. CONCLUSIONS: The results indicate that jobless working-age individuals with diabetes were significantly less likely to adhere to OAD medication than employed individuals.

AB - OBJECTIVE: To assess potential associations between joblessness and oral anti-diabetic (OAD) medication adherence in US diabetic working-age adults. STUDY DESIGN: A retrospective longitudinal panel design used pooled 2001-2007 Medical Expenditure Panel Survey (MEPS) data forming a nationally representative sample of diabetic individuals, ages 24-59 years. Pregnancy, seasonal job status, retired persons, a student designation, and those prescribed insulin were excluded. Adherence was measured using the proportion of days covered (PDC). A PDC $0.80 was classified as adherent. Descriptive statistics and multivariate regression analysis accounting for the MEPS' complex survey design were conducted. RESULTS: There were 2256 individuals (means: age 48.3 years [SD 8.15], body mass index 31.1 [SD 0.30], Charlson Comorbidity Index 0.37 [SD 0.79]) who met study criteria. Thirty-four percent were jobless at the first interview round and 29% remained jobless all 5 interview rounds during the 2-year panel period. Reasons cited for joblessness included: waiting to start a new job (73%) and unable to work due to illness or disability (20%). Negligible proportions cited staying home to care for family members or maternity leave as reasons for joblessness. Proportionately, more individuals were nonadherent (55%, SE 0.006). Joblessness was associated with a 16% significant reduction in the PDC (β -15.9, P < 0.001), and a 25% less likelihood of OAD medication adherence compared with those employed (odds ratio 0.75; 95% confidence interval, 0.64-0.90, P = 0.002), while holding all other variables constant. CONCLUSIONS: The results indicate that jobless working-age individuals with diabetes were significantly less likely to adhere to OAD medication than employed individuals.

KW - Diabetes

KW - Employment

KW - Job status

KW - Joblessness

KW - Medication adherence

KW - Medication use

UR - http://www.scopus.com/inward/record.url?scp=85027929934&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85027929934&partnerID=8YFLogxK

U2 - 10.1016/j.ehrm.2012.06.001

DO - 10.1016/j.ehrm.2012.06.001

M3 - Article

AN - SCOPUS:85027929934

VL - 3

JO - Health Outcomes Research in Medicine

JF - Health Outcomes Research in Medicine

SN - 1877-1319

IS - 3

ER -