• Chanhyun Park, Chiu-Chi Angela Chang, Boon Peng Ng, and Gary J Young.
• Health Outcomes Division, College of Pharmacy, The University of Texas at Austin, Austin, Texas, USA.
• J Eval Clin Pract. 2023 Feb 1; 29 (1): 136145136-145.

Rationale, Aims, And ObjectivesThis study aims to investigate how reported comprehension of the Medicare programme and its prescription drug benefits is associated with cost-related medication nonadherence (CRN) among Medicare beneficiaries with cardiovascular disease (CVD) risk factors.MethodsThis cross-sectional study used the 2017 Medicare Current Beneficiary Survey Public Use File data and included Medicare beneficiaries aged ≥65 years who reported having at least one CVD risk factor (i.e., hypertension, hyperlipidemia, diabetes, smoking and obesity) (n = 2821). A survey-weighted logistic model was used to examine associations between perceived difficulty of understanding the Medicare programme and its prescription drug benefits and CRN, controlling for beneficiaries' demographic (e.g., age) and clinical characteristics (e.g, comorbidities). This study further analyzed five subgroups based on the type of CVD risk factors involved.ResultsAmong Medicare beneficiaries with CVD risk factors, 14.4% reported CRN. Medicare beneficiaries with CVD risk factors who reported difficulty understanding the overall Medicare programme and its prescription drug benefits were more likely to report CRN, compared to those who reported easy understanding of the overall Medicare programme (OR = 1.50; 95% CI = 1.11-2.04; p = 0.009) and its prescription drug benefits (OR = 2.01; 95% CI = 1.52-2.66; p < 0.001). Similar results were obtained for the subgroups with obesity, hypertension or hyperlipidemia.ConclusionsPerceived difficulty of understanding the Medicare Programme and its prescription drug benefits is associated with CRN among Medicare beneficiaries with CVD risk factors, especially those with obesity, hypertension or hyperlipidemia. Monitoring and enhancing Medicare beneficiaries' overall understanding of the Medicare programme may reduce CRN.© 2022 John Wiley & Sons Ltd.

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