Tracey-Lea Laba1, Tom Lung2, Stephen Jan3, Anish Scaria4, Tim Usherwood5, Jo-Anne Brien6, Natalie Plant7, Stephen Leeder8. 1. BPharm(Hons), PhD, Senior Research Fellow and NHMRC Early Career Research Fellow, University of Sydney, Menzies Centre for Health Policy, School of Public Health, Faculty of Medicine and Health, NSW; University of British Columbia, Centre for Clinical Epidemiology and Evaluation and Centre for Health Services and Policy Research, School of Population and Public Health, Canada; George Institute for Global Health, Faculty of Medicine, University of New South Wales, NSW. tracey.laba@sydney.edu.au. 2. BComm, MSc, PhD, Postdoctoral Research Fellow, George Institute for Global Health, Faculty of Medicine, University of New South Wales, NSW; University of Sydney, Faculty of Medicine and Health, NSW. 3. PhD, Head of Health Economics and Process Evaluation Program, Senior Health Economist, Professor of Health Economics, George Institute for Global Health, Faculty of Medicine, University of New South Wales, NSW; University of Sydney, Faculty of Medicine and Health, NSW. 4. MSc, Statistical Programmer, George Institute for Global Health, Faculty of Medicine, University of New South Wales, NSW. 5. BSc, MBBS, MD, FRCP, FRACGP, Professor of General Practice, University of Sydney, Faculty of Medicine and Health, Sydney. 6. BPharm, BS (Pharm), PharmD, Professor of Clinical Pharmacy, St Vincent@s Hospital; University of Sydney, School of Pharmacy, Faculty of Medicine and Health, NSW. 7. BSc (Hons), MHSc (ClinDataMan), Clinical Research Associate, Northern Sydney Cancer Centre, Royal North Shore Hospital, Sydney. 8. AO, FRACP, FFPH, FAFPHM, FRACGP, Emeritus Professor of Public Health and Community Medicine, University of Sydney, Menzies Centre for Health Policy, School of Public Health, Faculty of Medicine and Health, NSW.
Abstract
BACKGROUND AND OBJECTIVES: This study investigated the effect of management - including home medicines reviews and chronic disease management plans funded through the Medicare Benefits Schedule - on self-reported medication non-adherence. METHOD: An observational cohort study including 244 individuals with an exacerbation of chronic illness enrolled into the Care Navigation randomised controlled trial of integrated care. Non-adherence was measured using the Morisky-Greene-Levine self-reported adherence tool. RESULTS: The cohort comprised an equal number of older men and women with, on average, three chronic diseases, receiving between five and 10 unique medications each month and visiting a general practitioner (GP) more than 50 times in the year prior to completing the questionnaire. Forty per cent reported non-adherence, which was greater in males (relative risk [RR]: 1.73; 95% confidence interval [CI]: 1.25, 2.54) and in patients reporting a recent fall (RR 1.40; 95% CI: 1.02, 1.89). GP-initiated chronic disease management programs did not influence adherence. DISCUSSION: Despite almost weekly contact with GPs, two in five patients were non-adherent. Better methods of encouraging adherence are needed.
BACKGROUND AND OBJECTIVES: This study investigated the effect of management - including home medicines reviews and chronic disease management plans funded through the Medicare Benefits Schedule - on self-reported medication non-adherence. METHOD: An observational cohort study including 244 individuals with an exacerbation of chronic illness enrolled into the Care Navigation randomised controlled trial of integrated care. Non-adherence was measured using the Morisky-Greene-Levine self-reported adherence tool. RESULTS: The cohort comprised an equal number of older men and women with, on average, three chronic diseases, receiving between five and 10 unique medications each month and visiting a general practitioner (GP) more than 50 times in the year prior to completing the questionnaire. Forty per cent reported non-adherence, which was greater in males (relative risk [RR]: 1.73; 95% confidence interval [CI]: 1.25, 2.54) and in patients reporting a recent fall (RR 1.40; 95% CI: 1.02, 1.89). GP-initiated chronic disease management programs did not influence adherence. DISCUSSION: Despite almost weekly contact with GPs, two in five patients were non-adherent. Better methods of encouraging adherence are needed.
Authors: Enayet K Chowdhury; Mark R Nelson; Michael E Ernst; Karen L Margolis; Lawrence J Beilin; Colin I Johnston; Robyn L Woods; Anne M Murray; Rory Wolfe; Elsdon Storey; Raj C Shah; Jessica E Lockery; Andrew M Tonkin; Anne B Newman; Jeff D Williamson; Walter P Abhayaratna; Nigel P Stocks; Sharyn M Fitzgerald; Suzanne G Orchard; Ruth E Trevaks; Geoffrey A Donnan; Richard Grimm; John J McNeil; Christopher M Reid Journal: Am J Hypertens Date: 2020-04-01 Impact factor: 3.080