What are the financial barriers to adherence to treatment in neurology?


Though there is a growing armamentarium of medical therapies to treat neurological disease, patient adherence to taking the medication is critical to their effectiveness. Medication nonadherence, e.g. patients not taking medication as prescribed or discontinuing before they finish the course, has been shown to seriously hurt health outcomes in neurology. One of the reasons for this may be financial barriers. Now, a new study published in ClinicoEconomics and Outcomes Research examines this further.
A research team from Massachusetts General Hospital set out to capture more accurate, specific and informative date on medication nonadherence in neurology in a study entitled “Patient-reported financial barriers to adherence to treatment in neurology.” The US team collected cross-sectional survey responses using an iPad as part of routine outpatient care in a neurology clinic over a three-month period. They merged this data with administrative sources of demographic and clinical information, insurance details for example, to form a fuller picture of how often and what the financial barriers to patients who fail to refill prescription medication.
Almost 3,000 adults who came to the clinic between July and September 2015 participated in the survey. The mean age of participants was 56 years, and 54% were female. Participants were comparable to nonparticipants with respect to gender and ethnicity but more often identified English as their preferred language. Two-hundred-and-sixty-five respondents (9.8%) reported nonadherence that varied by condition. These patients were more frequently Hispanic, living alone, and preferred a language other than English.

The study found that the magnitude of financial barriers to medication adherence appears to vary across neurological conditions and demographic characteristics.

Corresponding author of the study, Dr Lidia Moura, said “Our results suggest that one in ten of our patients with neurological problems have reported financial barriers to medication adherence. These findings are consistent with previous studies that found that trouble affording medications was the fourth leading reason for medication nonadherence among elderly patients. The study offers opportunities to improve outcomes in neurology patients through medication adherence and drive health policy in neurology.”

She continued, “The study also suggests that while the overall level of poor adherence due to costs is limited, cost-related barriers to medication adherence appear to be concentrated among the most cognitively- and socioeconomically vulnerable patients. Multiple strategies are needed to prospectively identify these vulnerable patients and to alter prescribing practices to enhance affordability and thereby long-term efficacy.”

Updated 9 March 2017