Table 4.
Unadjusted and adjusted associations of patient race/ethnicity and other socio-demographic, clinical, and provider factors with time to medication discontinuation, among those initiating antidementia medications in the second half of 2009.
| Unadjusted HR (95% CI) N=3,481 | Adjusted HR (95% CI) N=3458a | |
|---|---|---|
| Race and ethnicity | ||
| White | 1.00 | 1.00 |
| Black | 1.11 (0.97, 1.28) | 1.25 (1.08,1.44)** |
| Hispanic | 1.45 (1.27, 1.65)*** | 1.56 (1.34,1.82)*** |
| Initiation drug type | ||
| AChEI | 1.00 | |
| Memantine | 0.97 (0.88,1.07) | |
| Both prescribed at the same date | 0.93 (0.76,1.15) | |
| Sex | ||
| Male | 1.00 | |
| Female | 0.86 (0.78,0.95)** | |
| Age, n (%) | ||
| 65-69 years | 1.00 | |
| 70-74 years | 1.14 (0.91,1.42) | |
| 75-79 years | 1.11 (0.90,1.37) | |
| 80+ years | 1.08 (0.89,1.31) | |
| Part D low-income subsidy or Dually eligible for Medicaid ever in baseline | ||
| No Medicaid or low-income subsidy | 1.00 | |
| Low-income subsidy but no Medicaid | 0.77 (0.66,0.90)*** | |
| Medicaid | 0.77 (0.69,0.86)*** | |
| Primary care shortage area | ||
| Not a shortage area | 1.00 | |
| Partial shortage area | 0.96 (0.87,1.05) | |
| Full shortage area | 1.03 (0.88,1.19) | |
| Federally qualified health centers in county | ||
| 0 centers | 1.00 | |
| 1 center | 1.04 (0.89,1.21) | |
| 2 or more centers | 1.11 (0.97,1.27) | |
| Rural/urban area of residence | ||
| Large metro | 1.00 | |
| Small metro | 0.91 (0.81,1.01) | |
| Micropolitan | 0.97 (0.84,1.13) | |
| Non-core rural | 0.99 (0.84,1.18) | |
| Visits to primary care in baseline | ||
| 0 visits | 1.00 | |
| 1 visit | 1.14 (1.00,1.31)* | |
| 2 visits | 1.22 (1.06,1.39)** | |
| 3 or more visits | 1.26 (1.13,1.40)*** | |
| Any visits to neurologist in baseline | ||
| No | 1.00 | |
| Yes | 1.01 (0.89,1.14) | |
| Any visits to geriatrician in baseline | ||
| No | 1.00 | |
| Yes | 1.26 (0.90,1.77) | |
| Alzheimer's disease | ||
| No | 1.00 | |
| Yes | 1.04 (0.95,1.13) | |
| Duration since first Medicare claim for ADRD | ||
| Less than 1 year | 1.00 | |
| Less than 2 years | 0.94 (0.81,1.09) | |
| 2 to 5 years | 0.95 (0.82,1.09) | |
| More than 5 years | 1.00 (0.86,1.16) | |
| Charlson co-morbidity score | ||
| 0 | 1.00 | |
| 1 | 1.00 (0.81,1.23) | |
| 2 | 1.11 (0.91,1.35) | |
| 3 | 1.00 (0.82,1.22) | |
| 4 | 0.93 (0.76,1.14) | |
| 5 or more | 1.00 (0.84,1.20) | |
| Hospital admissions in baseline | ||
| None | 1.00 | |
| 1 | 0.93 (0.80,1.07) | |
| 2 or more | 0.99 (0.75,1.31) |
a
23 (0.7%) patients were removed from the full sample of 3,481 for discontinuation analysis due to missing data
*
p<.05
**
p<.01
***
p≤.001