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Continuous Access to Medication and Health Outcomes in Uninsured Adults With Type 2 Diabetes

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dc.contributor.advisor Milligan, Renee A.
dc.contributor.author Toulouse, Cheryl Dillard
dc.creator Toulouse, Cheryl Dillard
dc.date 2012-04-10
dc.date.accessioned 2012-06-18T20:57:10Z
dc.date.available NO_RESTRICTION en_US
dc.date.available 2012-06-18T20:57:10Z
dc.date.issued 2012-06-18
dc.identifier.uri https://hdl.handle.net/1920/7892
dc.description.abstract Background and Purpose: Achieving targets for HgbA1c, low density lipids (LDL), and blood pressure (BP) can improve outcomes in adults with diabetes. To meet targets, access to affordable and consistent medication is necessary. The Social Determinants of Health framework guided variable selection in this study that explored the relationship between continuous access to medication (CAM) and HgbA1c, LDL, BP, hospitalizations (HSPs), and emergency department visits (EDVs) in adults with type 2 diabetes who are uninsured and of low socioeconomic status. Hypothesis: CAM is related to improved HgbA1c, LDL, and BP, and reduced HSPs and EDVs. Methods: This within-subjects study was conducted in two steps using a sample that received healthcare on a mobile van and medications from a pharmaceutical program. Step1: Pre-Post (N = 65) exploratory analysis using Dependent t-Tests and McNemar’s tests. Step 2: Time-Series (N = 17) quasi-experimental analysis using RM-ANOVA. Pre-Post Results: CAM was related to improved HgbA1c (p = .003), LDL (p = .004), and systolic BP (p = .025). Time-Series Results: CAM was related to improved HgbA1c (p = .011) with a significant reduction in mean HgbA1c (-1.14%) from preintervention to postintervention (p = .014). Conclusions: Access to a consistent and reliable source of medication is essential to improving outcomes in adults with diabetes. In addition to providing excellent care, healthcare providers must foster opportunities to improve access to medication.
dc.language.iso en_US en_US
dc.subject diabetes en_US
dc.subject access to medication en_US
dc.subject uninsured en_US
dc.subject access to care en_US
dc.subject safety net clinic en_US
dc.subject HgbA1c en_US
dc.title Continuous Access to Medication and Health Outcomes in Uninsured Adults With Type 2 Diabetes en_US
dc.type Dissertation en
thesis.degree.name PhD in Nursing en_US
thesis.degree.level Doctoral en
thesis.degree.discipline Nursing en
thesis.degree.grantor George Mason University en


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