{"doi":"10.1002/acr.24397","title":"Access and Cost‐Related Nonadherence to Prescription Medications Among Lupus Patients and Controls: The Michigan Lupus Epidemiology and Surveillance Program","abstract":"OBJECTIVE: Medication access and adherence are important determinants of health outcomes. We investigated factors associated with access and cost-related nonadherence to prescriptions in a population-based cohort of systemic lupus erythematosus (SLE) patients and controls. METHODS: Detailed sociodemographic and prescription data were collected by structured interview in 2014-2015 from participants in the Michigan Lupus Epidemiology and Surveillance (MILES) cohort. We compared access between cases and frequency-matched controls and examined associated factors in separate multivariable logistic regression models. RESULTS: A total of 654 participants (462 SLE patients, 192 controls) completed the baseline visit; 584 (89%) were female, 285 (44%) were Black, and the mean age was 53 years. SLE patients and controls reported similar frequencies of being unable to access prescribed medications (12.1% versus 9.4%, respectively; P was not significant). SLE patients were twice as likely as controls to report cost-related prescription nonadherence in the preceding 12 months to save money (21.7% versus 10.4%; P = 0.001) but were also more likely to ask their doctor for lower cost alternatives (23.8% versus 15.6%; P = 0.02). Disparities were found in association with income, race, and health insurance status, but the main findings persisted after adjusting for these and other variables in multivariable models. CONCLUSION: SLE patients were more likely than controls from the general population to report cost-related prescription nonadherence, including skipping doses, taking less medicine, and delaying filling prescriptions; yet, <1 in 4 patients asked providers for lower cost medications. Consideration of medication costs in patient decision-making could provide a meaningful avenue for improving access and adherence to medications.","journal":"Arthritis Care & Research","year":2020,"id":103315,"datarank":1.1621124443068716,"base_score":3.258096538021482,"endowment":3.258096538021482,"self_citation_contribution":0.4887144807032224,"citation_network_contribution":0.6733979636036492,"self_endowment_contribution":0.4887144807032224,"citer_contribution":0.6733979636036492,"corpus_percentile":82.36249709909492,"corpus_rank":2281,"citation_count":25,"citer_count":20,"citers_with_citation_signal":17,"citers_with_endowment":17,"datacite_reuse_total":0,"is_dataset":true,"is_dataset_confidence":0.6695,"is_data_producer":false,"deposit_databanks":null,"is_oa":true,"file_count":0,"downloads":0,"has_version_chain":false,"published_date":"2020-01-01","fair_score":null,"fair_percentile":null,"algorithm_id":"datarank_citation_only_1hop_v6","ranking_scope":"data_only","authors":[{"id":488790,"name":"Wendy Marder","orcid":"0000-0001-7963-4206","position":1,"is_corresponding":false},{"id":230374,"name":"Sioḃán D. Harlow","orcid":"0000-0002-9899-356X","position":2,"is_corresponding":false},{"id":379278,"name":"Afton L. Hassett","orcid":"0000-0003-2982-484X","position":3,"is_corresponding":false},{"id":503341,"name":"Suzanna M. Zick","orcid":"0000-0003-0914-4927","position":4,"is_corresponding":false},{"id":18418,"name":"Caroline Gordon","orcid":"0000-0002-1244-6443","position":5,"is_corresponding":false},{"id":433983,"name":"Kamil E. Barbour","orcid":"0000-0003-0546-6742","position":6,"is_corresponding":false},{"id":433984,"name":"Charles G. Helmick","orcid":"0000-0001-5036-8215","position":7,"is_corresponding":false},{"id":252147,"name":"Lu Wang","orcid":"0000-0002-0073-0666","position":8,"is_corresponding":false},{"id":503342,"name":"Jiha Lee","orcid":"0000-0002-6402-6563","position":9,"is_corresponding":false},{"id":503343,"name":"Amrita Padda","orcid":"0000-0001-8186-1096","position":10,"is_corresponding":false},{"id":315994,"name":"W. Joseph McCune","orcid":null,"position":11,"is_corresponding":false},{"id":226871,"name":"Emily C. Somers","orcid":"0000-0001-5234-3978","position":12,"is_corresponding":false},{"id":503340,"name":"Deeba Minhas","orcid":"0000-0001-9532-6828","position":0,"is_corresponding":true}],"reference_count":44,"raw_metadata":null,"created_at":"2026-07-18T22:42:17.920911Z","pmid":"32741110","pmcid":"PMC9219566","fwci":null,"citation_percentile":null,"influential_citations":0,"oa_status":null,"license":null,"views":0,"total_file_size_bytes":0,"version_count":0,"fair_f":null,"fair_a":null,"fair_i":null,"fair_r":null,"fair_zscore":null,"fair_rationale":null,"fair_model":null,"fair_agent_version":null,"fair_fulltext_source":null,"fair_has_llm":null,"fair_computed_at":null,"clinical_trials":[],"software_tools":[],"db_accessions":[],"linked_datasets":[],"topics":[]}