Patient Characteristics Associated with Medication Adherence
TLDR
Assessment of patient characteristics associated with medication adherence across eight diseases found adherence for those with one condition was higher in males, Caucasians, older patients, and those living in areas with higher education rates and higher income, and in the total population, adherence increased with lower comorbidity and increased number of medications.Abstract:
The lack of adherence to prescribed medication is an important health challenge. Despite evidence indicating the therapeutic benefit for adhering to a prescribed regimen, many patients do not take medications as prescribed. Several studies have been conducted examining medication adherence for various conditions, and adherence has consistently been found to be suboptimal.1–7 Failure to take medication as prescribed increases the risk that patients will not get the intended benefit, often leading to negative sequelae.3,8–12 Further, not adhering to one’s prescribed medications is likely to result in higher healthcare costs overall.10 Thus, understanding factors associated with maintaining one’s medication regimen is important to patients, providers, and health plans.
External factors such as cost and access to the needed medication play a role in non-adherence. However, within our integrated health care system, where most patients have access to care, a covered pharmacy benefit, and easy access to pharmacies, one might expect a lower rate of non-adherence than in the general population. Pharmacies are available in all clinics owned by the medical group. In addition, phone-in, mail order, and internet prescription refill options allow patients the ability to order medications 24 hours a day. Nevertheless, the health system has identified non-adherence as a major area of concern.
While the literature has reported some evidence of variation of adherence by age, race, co-morbidity status, and socioeconomic status (SES) (higher adherence in those older, white, lower co-morbidity, and higher SES),8,9,13–17 the majority of studies conducted have examined adherence within a given disease state. Few have examined adherence across multiple conditions to determine whether associations between adherence and patient characteristics are consistent. Such information could be helpful in health systems such as ours to develop focused interventions. Therefore, to increase the understanding of medication adherence in our population, we examined adherence across multiple health conditions, examining associated patient and drug-related characteristics. The purpose of this paper is to report on the patient characteristics associated with adherence within this large integrated health system.read more
Citations
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Journal ArticleDOI
Determinants of adherence to diabetes medications: Findings from a large pharmacy claims database
M. Sue Kirkman,Megan T. Rowan-Martin,Rebecca Levin,Vivian Fonseca,Julie A. Schmittdiel,William H. Herman,Ronald E. Aubert +6 more
TL;DR: Adherence was independently associated with older age, male sex, higher education, higher income, use of mail order versus retail pharmacies, primary care versus nonendocrinology specialist prescribers, higher daily total pill burden, and lower out-of-pocket costs.
Journal ArticleDOI
Patient-reported side effects, concerns and adherence to corticosteroid treatment for asthma, and comparison with physician estimates of side-effect prevalence: a UK-wide, cross-sectional study
TL;DR: An unexpectedly large proportion of people with asthma experienced side effects and had strong concerns about their treatment, which compromised adherence, which has implications for the design of interventions to optimise asthma control through improved adherence.
Journal ArticleDOI
Disparities in hypertension and cardiovascular disease in blacks: The critical role of medication adherence.
Keith C. Ferdinand,Kapil Yadav,Samar A. Nasser,Helene D. Clayton-Jeter,John C. Lewin,Dennis R. Cryer,Fortunato Fred Senatore +6 more
TL;DR: The relationship between disparities and medication adherence likely plays a role in persistent disparities in cardiovascular morbidity and mortality, and eight practical approaches to addressing medication adherence with the potential to attenuate disparities were identified.
Journal ArticleDOI
Improving Medication Adherence in Cardiometabolic Disease: Practical and Regulatory Implications
Keith C. Ferdinand,Fortunato Fred Senatore,Helene D. Clayton-Jeter,Dennis R. Cryer,John C. Lewin,Samar A. Nasser,Mona Fiuzat,Robert M. Califf +7 more
TL;DR: The scope of CVD nonadherence is summarized, key U.S. Food and Drug Administration initiatives are described, potential targets for improvement are identified, and key adherence factors, methods, and technological applications for simplifying regimens and enhancing adherence are described.
Journal ArticleDOI
Sex and gender influences on pharmacological response: an overview.
Flavia Franconi,Ilaria Campesi +1 more
TL;DR: The influence of sex and gender on access to care and emotional factors, including patients and care provider dyads, the placebo effect, adherence, and safety profiles, and differences in drug responses, mainly for antidiabetic drugs, have been described.
References
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Adherence to long-term therapies: evidence for action.
TL;DR: This report highlights the need for a multi-disciplinary approach to adherence, emphasizes system factors that need to be addressed in successfully implementing adherence-enhancing strategies, and provides illustrative examples of the ways in which professionals have contributed in their own fields of expertise including cardiovascular care among other fields.
Journal ArticleDOI
Adherence to Long-Term Therapies: Evidence for Action:
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TL;DR: In this paper, a comprehensive report entitled Adherence to Long-Term Therapies: Evidence for Action w1x was published, focusing on nine chronic conditions and their risk factors.
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TL;DR: The research in this field needs advances, including improved design of feasible long-term interventions, objective adherence measures, and sufficient study power to detect improvements in patient-important clinical outcomes.
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A systematic review of the associations between dose regimens and medication compliance
TL;DR: A review of studies that measured compliance using EM confirmed that the prescribed number of doses per day is inversely related to compliance.
Journal ArticleDOI
A Systematic Review of Adherence With Medications for Diabetes
TL;DR: It is confirmed that many patients for whom diabetes medication was prescribed were poor compliers with treatment, including both OHAs and insulin, however, electronic monitoring systems were useful in improving adherence for individual patients.