Journal Article

The association of smoking with medical treatment adherence in the workforce of a large employer

Sherman, Bruce W., Lynch, Wendy

2014

Overview

Prior descriptive epidemiology studies have shown that smokers have lower compliance rates with preventive care services and lower chronic medication adherence rates for preventive care services in separate studies. The goal of this study was to perform a more detailed analysis to validate both of these findings for current smokers versus nonsmokers within the benefit-covered population of a large US employer. This study involved the analysis of incurred medical and pharmacy claims for employee and spouse health plan enrollees of a single US-based employer during 2010. Multivariate regression models were used to compare data by active or never-smoker status for preventive care services and medication adherence for chronic conditions. Analysis controlled for demographic variables, chronic condition prevalence, and depression. Controlling for demographic variables and comorbid conditions, smokers had significantly lower cancer screening rates, with absolute reductions of 6%-13%. Adherence to chronic medication use for hypertension was also significantly lower among smokers, with nearly 7% fewer smokers having a medication possession ratio of ≥80%. Smokers were less adherent to depression medications (relative risk =0.79) than nonsmokers (P=0.10). While not statistically significant, smokers were consistently less adherent to all other medications than nonsmokers. Current smokers are less compliant with recommended preventive care and medication use than nonsmokers, likely contributing to smoking-related employer costs. Awareness of these care gaps among smokers and direct management should be considered as part of a comprehensive population health-management strategy.

• Publisher: Dove Medical Press Limited,Taylor & Francis Ltd,Dove Press,Dove Medical Press
• Subject: chronic condition management / Chronic illnesses / Cost shifting / disease management / Disease prevention / Employees / employer health benefits / Employers / Health aspects / Health care expenditures / Health care policy / health care utilization and costs / Health risk assessment / Health services utilization / Indoor air quality / Labor force / Lifestyles / Medical research / Mental depression / Occupational safety and health / Original Research / Outdoor air quality / Patient compliance / Patient Protection & Affordable Care Act 2010-US / Pharmacy / Population / Preventive medicine / Primary care / Productivity / Public health / Smoking / Tobacco / Workers compensation