Victoria Socha

DocwireNews

Social Determinants of Health and Adherence to Patiromer Patients with chronic kidney disease commonly develop hyperkalemia, a serious and frequent complication that can negatively affect continuation of beneficial evidence-based therapies. Recent developments in the treatment of chronic hyperkalemia in patients with CKD include patiromer. According to Nathan Kleinman, PhD, and colleagues, the optimal use of therapies such as patiromer depends on patient adherence.Social determinants of health (SDOH) are key and may have an impact on medical conditions as well as adherence to prescription medications. Dr. Kleinman et al conduced an analysis to examine the association between SDOH and adherence to or nonuse of patiromer for the treatment of hyperkalemia. Results were reported online in <a href="https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0281775" target="_blank" rel="noopener">PLOS One</a> [doi.org/10.1371/journal.pone.0281775].The observational, retrospective, real-world claims analysis included adults with prescriptions for patiromer and available prescription data for 6 and 12 months pre- and postindex prescription data. Prescription data were obtained from Symphony Health&rsquo;s Dataverse during 2015 to 2020. Information&nbsp; on SDOH was gathered from census data. Subgroups included patients with heart failure, hyperkalemia-confounding prescriptions, and any CKD stages.Adherence was defined as &gt;80% of proportion of days covered&nbsp; (PDC) for &ge;60 days and &ge;6 months. Abandonment of patiromer was defined as a portion of reversed claims. Logistic regression controlling for similar factors and initial days&rsquo; supply were used to define abandonment models.At 60 days, 48% of patients had a patiromer PDC &gt;80%. At 6 months, 25% met that definition. There were associations between higher PDC and older age, male sex, Medicare/Medicaid coverage, prescription from a nephrologist, and receiving renin-angiotensin-aldosterone system inhibitors. There were correlations between lower PDC and higher out-of-pocket costs, unemployment, poverty, disability, and any CKD stage with comorbid heart failure. Regions with higher education and income levels had better PDC.In summary, the authors said, &ldquo;SDOH (unemployment, poverty, education, income) and health indicators (disability, comorbid CKD, heart failure) were associated with low PDC. Prescription abandonment was higher in patients with prescribed higher dose, higher out-of-pocket costs, those with disability, or designated White. Key demographic, social, and other factors play a role in drug adherence when treating life-threatening abnormalities such as hyperkalemia and may influence patient outcomes.&rdquo;

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Social Determinants of Health and Adherence to Patiromer

Hyperkalemia

Results of an analysis to examine the association between SDOH and adherence to or nonuse of patiromer for the treatment of hyperkalemia. 

SDH and Adherence to Patiromer

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