Daniel J Coletti1,2, Hara Stephanou3, Nissa Mazzola4, Joseph Conigliaro5, JoAnne Gottridge3, John M Kane1. 1. Department of Psychiatry, The Zucker Hillside Hospital, North Shore-LIJ Health System, Glen Oaks, NY, USA. 2. Division of General Internal Medicine, North Shore University Hospital, North Shore-LIJ Health System, Manhasset, NY, USA. 3. Department of Medicine, North Shore-LIJ Health System, Manhasset, NY, USA. 4. College of Pharmacy and Health Sciences, St. John's University, Queens, NY, USA. 5. Division of General Internal Medicine, Department of Medicine, North Shore-LIJ Health System, Manhasset, NY, USA.
Abstract
RATIONALE, AIMS AND OBJECTIVES: Identifying medication discrepancies across transitions of care is a common patient safety problem. Research examining relations between medication discrepancies and adherence, however, is limited. The objective of this investigation is to explore the relations between adherence and patient-provider medication discrepancies, and to test the hypothesis that non-adherence would be associated with medication discrepancies. METHODS: Three hundred twenty-eight outpatients completed a current medication list and measures of health literacy, adherence, perceived physical functioning and subjective well-being. Patient lists were compared with active medications in the electronic medical record. Multivariate analyses identified demographic, clinical and patient-reported variables associated with discrepancies involving prescribed daily medications. RESULTS: Despite high rates of self-reported adherence, patients reported taking fewer medications than the number of active medications in their medical record (3.79 vs. 4.83, P < 0.001). We identified one or more discrepancies in most records (294/328 or 89.6%). Identified discrepancies were completely reconciled in only 21.1% of patients with discrepancies. Discrepancies were associated with lower health literacy, poorer physical health status and subjective well-being, and poorer adherence to the regimen patients believed they had been prescribed. Multivariate analysis indicated that the number of medical record-reported medications and subjective well-being independently predicted the presence of discrepancies. CONCLUSIONS: Findings suggest a complex relation between treatment adherence and medication discrepancies in which patient well-being and regimen complexity work in tandem to create discordance between patient and provider medication plans. Simplifying regimens when possible and attending to patient life satisfaction may improve adherence to a regimen constructed jointly between patient and provider.
RATIONALE, AIMS AND OBJECTIVES: Identifying medication discrepancies across transitions of care is a common patient safety problem. Research examining relations between medication discrepancies and adherence, however, is limited. The objective of this investigation is to explore the relations between adherence and patient-provider medication discrepancies, and to test the hypothesis that non-adherence would be associated with medication discrepancies. METHODS: Three hundred twenty-eight outpatients completed a current medication list and measures of health literacy, adherence, perceived physical functioning and subjective well-being. Patient lists were compared with active medications in the electronic medical record. Multivariate analyses identified demographic, clinical and patient-reported variables associated with discrepancies involving prescribed daily medications. RESULTS: Despite high rates of self-reported adherence, patients reported taking fewer medications than the number of active medications in their medical record (3.79 vs. 4.83, P < 0.001). We identified one or more discrepancies in most records (294/328 or 89.6%). Identified discrepancies were completely reconciled in only 21.1% of patients with discrepancies. Discrepancies were associated with lower health literacy, poorer physical health status and subjective well-being, and poorer adherence to the regimen patients believed they had been prescribed. Multivariate analysis indicated that the number of medical record-reported medications and subjective well-being independently predicted the presence of discrepancies. CONCLUSIONS: Findings suggest a complex relation between treatment adherence and medication discrepancies in which patient well-being and regimen complexity work in tandem to create discordance between patient and provider medication plans. Simplifying regimens when possible and attending to patient life satisfaction may improve adherence to a regimen constructed jointly between patient and provider.
Authors: Ariel R Green; Cynthia M Boyd; Kathy S Gleason; Leslie Wright; Courtney R Kraus; Ruth Bedoy; Bianca Sanchez; Jonathan Norton; Orla C Sheehan; Jennifer L Wolff; Emily Reeve; Matthew L Maciejewski; Linda A Weffald; Elizabeth A Bayliss Journal: J Gen Intern Med Date: 2020-07-29 Impact factor: 5.128
Authors: Kelly L Hayward; Patricia C Valery; W Neil Cottrell; Katharine M Irvine; Leigh U Horsfall; Caroline J Tallis; Veronique S Chachay; Brittany J Ruffin; Jennifer H Martin; Elizabeth E Powell Journal: BMC Gastroenterol Date: 2016-09-13 Impact factor: 3.067
Authors: Kelly L Hayward; Patricia C Valery; Preya J Patel; Catherine Li; Leigh U Horsfall; Penny L Wright; Caroline J Tallis; Katherine A Stuart; Michael David; Katharine M Irvine; Neil Cottrell; Jennifer H Martin; Elizabeth E Powell Journal: Pharmaceuticals (Basel) Date: 2021-11-23