At Express Scripts, we spend a lot of time studying human behavior to gain a better understanding of how our patients make health decisions and what obstacles might prevent them from achieving optimal health outcomes.
With 42 million Americans providing unpaid care to an ill or disabled adult, we sought to learn more about how the responsibility of caring for another impacts a person’s health. We discovered that the stress of being a caregiver could have a detrimental effect on a person’s emotional and physical well-being.
The Stress Pack
In our study, we paired an analysis of Express Scripts’ prescription drug claims data with a telephone survey of more than 12,000 commercially insured individuals ages 18 to 65.
The data revealed that use of medications to treat conditions for which stress is the common denominator, including high blood pressure, depression, anxiety and ulcers, is higher among caregivers. We saw the widest difference in the use of medications to treat anxiety, with caregivers 29% more likely to use an anti-anxiety medication than non-caregivers.
Furthermore, our study suggests caregivers are more likely to rate themselves in poorer health compared to non-caregivers (15% vs. 12%), and are not making good health decisions. Adherence rates for caregivers who use an antidepressant – a medication patients must take as prescribed to see a benefit – are relatively worse than for non-caregivers (67% vs. 73%). Across all health conditions, 64% of caregivers are adherent to their medication therapy, compared to 68% of non-caregivers.
medication use among caregivers and noncaregivers
Life of a Caregiver
Prevalence data and adherence rates only tell part of the story. To fully understand what keeps caregivers on the path to good health, we need to learn more about their daily lives. After controlling for factors such as age, gender, and income, we discovered:
- A higher proportion of caregivers report being unhappy (5.3% vs. 3.5%).
- Only 20% caregivers reside in the same household as the patients in their care. 52% live within 15 miles of their primary care recipient, and another 27% live more than 15 miles away.
- Roughly one-third provide care for more than one person, and two-thirds of respondents provide care for a parent, older relative, sibling or friend as opposed to a spouse or adult child.
- At the time of the survey, approximately 36% of caregivers had increased the amount of care they provided in the past month; 15% had decreased the amount of care.
- Care-giving is a long-term endeavor: 8.5% of caregivers reported they were new to the role and only 3.8% said they stopped providing care in the past month.
- The average age for caregivers is 52 years old, and most are female (63% female vs. 37% male).
Knowing that a caregiver may spend a significant amount of time traveling to care for a person, or have multiple people in their care, Express Scripts' specialist pharmacists can help. Their unique practice of pharmacy can tailor support and interventions for these patients, whether it’s overcoming obstacles to medication adherence or identifying signs of depression in the patient or the caregiver.
And existing resources, such as home delivery, a web portal specifically for caregivers, and our mobile app, which offer alerts, prescription histories, adherence reminders, and more, can reduce the administrative burden that comes with being a caregiver.
Caring for the Caregiver
Caregivers are the unsung heroes of our healthcare system, helping many individuals live with dignity within their community. However, if the responsibility of care-giving takes a toll on a person’s health, it impairs their ability to care for another, and reduce their own quality of life.
As the boomer population ages, care-giving could become more challenging. The duality of a caregiver as a patient is important to consider for payers when developing tools, resources, and policies for their employees, and to facilitate the care process.
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