Sunil Kripalani1, Margaret E Gatti, Terry A Jacobson. 1. Section of Hospital Medicine, Division of General Internal Medicine and Public Health, Department of Medicine, Vanderbilt University, Nashville, TN 37232, USA. sunil.kripalani@vanderbilt.edu
Abstract
OBJECTIVE: To examine patients' use of medication management strategies (e.g., reminders, pill boxes), and to determine how their use influences the relationship between patient characteristics and medication adherence. METHODS: Retrospective and cross-sectional study of 434 patients with coronary heart disease, examining both refill adherence and self-reported adherence. RESULTS: The most common strategy for managing refills was seeing a near empty pill bottle (89.9%), and for managing daily medications, it was associating medications with daily events (80.4%). Age<65 (OR = 1.7), as well as marginal (OR = 2.0) or inadequate health literacy (OR = 1.9), was independently associated with low refill adherence. Patients <65 also had lower self-reported adherence (OR = 1.8). Adjustment for use of medication management strategies did not substantially change these relationships. Reliance on reminders from friends or family to take medications, or waiting to refill a medicine only when the bottle was near empty, each were associated with 3-fold greater odds of non-adherence. CONCLUSION: Age <65 and marginal or inadequate health literacy were independently associated with medication non-adherence. Use of medication management strategies did not explain these relationships. PRACTICE IMPLICATIONS: The strategies which patients report using to assist with managing medication refills and daily medication use may be ineffective.
OBJECTIVE: To examine patients' use of medication management strategies (e.g., reminders, pill boxes), and to determine how their use influences the relationship between patient characteristics and medication adherence. METHODS: Retrospective and cross-sectional study of 434 patients with coronary heart disease, examining both refill adherence and self-reported adherence. RESULTS: The most common strategy for managing refills was seeing a near empty pill bottle (89.9%), and for managing daily medications, it was associating medications with daily events (80.4%). Age<65 (OR = 1.7), as well as marginal (OR = 2.0) or inadequate health literacy (OR = 1.9), was independently associated with low refill adherence. Patients <65 also had lower self-reported adherence (OR = 1.8). Adjustment for use of medication management strategies did not substantially change these relationships. Reliance on reminders from friends or family to take medications, or waiting to refill a medicine only when the bottle was near empty, each were associated with 3-fold greater odds of non-adherence. CONCLUSION: Age <65 and marginal or inadequate health literacy were independently associated with medication non-adherence. Use of medication management strategies did not explain these relationships. PRACTICE IMPLICATIONS: The strategies which patients report using to assist with managing medication refills and daily medication use may be ineffective.
Authors: Ashli A Owen-Smith; David H Smith; Cynthia S Rand; Jeffrey O Tom; Reesa Laws; Amy Waterbury; Andrew Williams; William M Vollmer Journal: Perm J Date: 2016-06-29
Authors: Chandra Y Osborn; Kenneth A Wallston; Adam Shpigel; Kerri Cavanaugh; Sunil Kripalani; Russell L Rothman Journal: Patient Educ Couns Date: 2013-02-21
Authors: Jia-Rong Wu; Barbara Mark; George J Knafl; Sandra B Dunbar; Patricia P Chang; Darren A DeWalt Journal: Heart Lung Date: 2019-06-07 Impact factor: 2.210