TY - JOUR
T1 - Elderly patients' preferences and experiences with providers in managing their drug costs
AU - Tseng, Chien Wen
AU - Dudley, R. Adams
AU - Brook, Robert H.
AU - Keeler, Emmett
AU - Steers, W. Neil
AU - Alexander, G. Caleb
AU - Waitzfelder, Beth E.
AU - Mangione, Carol M.
PY - 2007/12
Y1 - 2007/12
N2 - OBJECTIVES: To determine whether elderly patients with high drug expenditures want and receive providers' help in managing drug costs. DESIGN: Cross-sectional survey. SETTING: A Medicare managed care plan (>400,000 members) in one state in 2002. PARTICIPANTS: One thousand one hundred six seniors (62% response rate) sampled so that half exceeded caps on their drug benefits the previous year, and all had total drug expenditures in the top quartile of members in their cap level. MEASUREMENTS: Participants' preferences and experiences with providers discussing costs and participation in choosing medications. RESULTS: Two-thirds reported difficulty paying for medications, and one-fourth decreased medication use because of cost. Most wanted providers to ask about medication affordability (81%), consider cost (86%), offer choices (70%), and to persuade them or decide for them which medication to use (88%), but few said providers asked about affordability (17%), usually or always discussed prices (19%), or offered choices (45%), although nearly all said providers chose their medications (93%). Sixty-two percent had asked providers for help with drug costs, although 34% who used less medication because of cost or had difficulty paying for medications had not asked for help. CONCLUSION: Providers should be aware that elderly patients want their help in managing drug costs but do not always receive it or ask for help when they need it. Providers could improve communication by initiating conversations about cost and by asking patients about preferences when prescribing.
AB - OBJECTIVES: To determine whether elderly patients with high drug expenditures want and receive providers' help in managing drug costs. DESIGN: Cross-sectional survey. SETTING: A Medicare managed care plan (>400,000 members) in one state in 2002. PARTICIPANTS: One thousand one hundred six seniors (62% response rate) sampled so that half exceeded caps on their drug benefits the previous year, and all had total drug expenditures in the top quartile of members in their cap level. MEASUREMENTS: Participants' preferences and experiences with providers discussing costs and participation in choosing medications. RESULTS: Two-thirds reported difficulty paying for medications, and one-fourth decreased medication use because of cost. Most wanted providers to ask about medication affordability (81%), consider cost (86%), offer choices (70%), and to persuade them or decide for them which medication to use (88%), but few said providers asked about affordability (17%), usually or always discussed prices (19%), or offered choices (45%), although nearly all said providers chose their medications (93%). Sixty-two percent had asked providers for help with drug costs, although 34% who used less medication because of cost or had difficulty paying for medications had not asked for help. CONCLUSION: Providers should be aware that elderly patients want their help in managing drug costs but do not always receive it or ask for help when they need it. Providers could improve communication by initiating conversations about cost and by asking patients about preferences when prescribing.
KW - Decision making
KW - Medicare drug benefit
KW - Patient-provider communication
KW - Prescription drug costs
UR - http://www.scopus.com/inward/record.url?scp=36849059802&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=36849059802&partnerID=8YFLogxK
U2 - 10.1111/j.1532-5415.2007.01445.x
DO - 10.1111/j.1532-5415.2007.01445.x
M3 - Article
C2 - 17944892
AN - SCOPUS:36849059802
SN - 0002-8614
VL - 55
SP - 1974
EP - 1980
JO - Journal of the American Geriatrics Society
JF - Journal of the American Geriatrics Society
IS - 12
ER -