185216 Racial and Ethnic Disparities in Prescription Medication Use in the U.S.:

Tuesday, October 28, 2008: 1:30 PM

Dima Qato, PharmD, MPH , University of Chicago, Chicago, IL
Stacy Lindau, MD, MAPP , University of Chicago, Chicago, IL
Phil Schumm, MA , University of Chicago, Chicago, IL
Rena Conti, PhD , University of Chicago, Chicago, IL
G. Caleb Alexander, MD, MS , MacLean Center for Clinical Medical Ethics; Section of General Internal Medicine, University of Chicago, Chicago, IL
Research Objective: (1) To examine racial and ethnic disparities in prescription medication use among the U.S. older adult population. Study Design: The National, Social life, Health and Aging Project (NSHAP) dataset was used for this analysis. NSHAP is a nationally representative probability sample of 3,005 community-dwelling persons 57 to 85 years of age from households across the United States, with over-sampling of African-Americans, Latinos, men, and individuals 75 to 84 years of age (75.5% weighted response rate). Household interviews were conducted between July 2005 and March 2006. Medications were recorded by direct observation using a computerized log. Multivariate logistic regression was used to examine the factors associated with differences in prescription medication use among non-Hispanic whites (Whites), non-Hispanic blacks (Blacks), and Hispanics (any race). Models were adjusted for demographic (age and gender), socio-economic (household income, insurance status, education, employment status) and health-related (self-reported health and co-morbid conditions) characteristics.Results: Overall, 82% of older adults use a prescription medication. Preliminary results indicate that there are differences in prescription utilization by race/ethnicity. In unadjusted analyses, in comparison to Whites, the use of at least one prescription medication was not significantly different in Blacks (OR: 1.1 (CI: 0.80, 1.57), but significantly less among Hispanics (OR: 0.53(CI: 0.39, 0.73). After adjusting for demographic and health-related characteristics, Whites were significantly more likely to be using a prescription medication than either Blacks (OR: 0.49(CI: 0.32, 0.78)) and Hispanics ((OR: 0.43 (CI: 0.27, 0.69)). However, when adjusting for income, education, insurance status, and employment status, in comparison to Whites, Blacks were equally likely [(OR: 0.99 (CI: 0.52, 1.9)], but Hispanics were less likely [OR: 0.70 (CI: 0.34, 1.4] to use at least one prescription medication. Conclusions:These data provide updated, nationally representative estimates of racial and ethnic differences in prescription medication use among community dwelling elders. Differences in race/ethnicity were significantly associated with prescription medication use among older adults in the United States. While differences in demographic and health characteristics do not explain the observed disparities in prescription medication use across racial/ethnic groups, socio-economic disparities may, especially for Blacks. More research is needed to identify unobserved factors associated with race/ethnicity responsible for differences in prescription medication use that may be associated with increased morbidity that is potentially modifiable by clinical practice.

Learning Objectives:
1. Understand racial/ethnic disparities in prescription medication use in older adults 2. Discuss implications of prescription use disparities on the health of minorities in the US.

Keywords: Health Disparities, Elderly

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: Public health researcher and clinical pharmacist studying the role of medications, including prescription drugs, in improving overall health in older adults.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.