Patient Non-Compliance With Medications. 3 rd Year Research Project Class of 2007. Introduction. Medication non-compliance …..the world’s “ other drug problem” 4. Medication Non-Compliance. As dangerous and costly as many illnesses
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3rd Year Research Project
Class of 2007
…..the world’s “other drug problem”4
(i.e. hospitalizations, development of additional illnesses/complications, exacerbation of the disease or disease progression, premature disability, or death)
Compliance, simply defined as “agreement.” With regard to medicine, compliance means agreeing to take medicine(s) as directed, and then following through with that agreement…..accepting the responsibility of taking medicine(s) as agreed8
Adherence is defined as the extent to which a patient’s health behavior coincides with their physician’s recommendations, whether taking medications or following advice for some type of behavioral change
The Role of the Patient-Physician Relationship and Satisfaction with Care
(Thomas H. Wroth, MD, MPH and Donald E. Pathman, MD, MPH )
– Prescription primary non-adherence is prevalent in the rural South. Adherence may be improved by remedying patient dissatisfaction and lack of confidence in their physicians as well as addressing transportation barriers
– A pharmacy care program led to increasesin medication adherence, medication persistence, andclinically meaningful reductions in BP, whereasdiscontinuation of the program was associated withdecreased medication adherence and persistence
To identify the factors that contribute to patient non-adherence with medications in an effort to optimize patient care and reduce morbidity and mortality
Age 18 years old
Taking 1 prescription medication not under the exclusion criteria*
Registered as FCC patient for > 1 year
Last visit to FCC w/in 6 months
*special inclusion for ASA for cardiovascular risk prevention and calcium with vitamin D for postmenopausal women not on HRT
Age < 18 years old
Pts. with dementia or cognitive impairment requiring assistance or special needs
FCC patient for < 1 yr.
Last visit to FCC > 6 m.
Any medication(s) not taken on a scheduled basis
1. Circle your gender:
2. Circle your ethnicity (optional)
Caucasian Hispanic Africanamerican Asian Philipino American-Indian Other
3. Circle the language or languages that you speak:
English Spanish English and Spanish other
4. How old are you? (Circle the one that apply)
18-30 31-45 46-65 65 or more
5. How long have you been a patient in Family Care Clinic?
1-3 years 3-6 years more than 6 years
6. What is your education level? (Circle the one that applies better to you)
A. Don’t know how to read
B. Can read with difficulty
C. Can read very well
D. Finish elementary school
E. Finish High school
F. More than high school
7. What kind of insurance do you have?
MISP MEDICAL MEDICARE IEHP Exclusive Care MOLINA Self Paid Pending
8. Do you know the medications you are taking? Yes No
9. Do you have the mediations with you?
10. Can you name them? Yes No
11. Do you know what the medications you are taking are for? Yes No
12. How many medications are you taking?
13. How many times a day do you have take your medicines?
14. Where do you get your medications?
RCRMC Other Pharmacy
15.What do you do when you run out of medication? (Circle what happens most often)
A. Call the pharmacy
B. Call the doctor’s office
C. Call the special line to refill medications
D. Go to the emergency room
E. Stop taking the medication
16.What are the reason(s) that you run out of medication? (you can choose more than one)
[If you choose more than one, please put* next to the most common reason]
17. Did you know there is a special phone line to refill your prescriptions over the phone
18. If yes Have you ever use it? Yes No
If yes, were you able to refill your medications through it? Yes No
If Not, you couldn’t do it because:
A. Didn’t understand how to use it?
B. Line was too busy most of the time and couldn’t get through it
C. Unable to spell the name of your medication
D. Left message over the phone but didn’t get a call from the Dr. telling you that your prescriptions were ready.
19. Reasons why you don’t take your medications as prescribed: (Circle all the reasons that apply to you)
20. What motivates you the most to take your medications? (Circle all that apply)
Put * next to the main reason
21. Please write down any suggestions to improve your own compliance with your medications
-TOTAL OF PATIENTS INTERVIEWED→ 296
-NOT ALL PATIENTS ANSWERED ALL THE QUESTIONS
-OF 21 QUESTIONS 13 (62%), WERE ANSWERED BY MORE THAN 290 PATIENTS
-6 (23%) QUESTIONS WERE ANSWERED FOR AT LEAST MORE THAN 250 PATIENTS, MOST OF THESE QUESTIONS WERE REGARDING
KNOWLEDGE OF MEDICATIONS BEING TAKEN
Medication Non-Adherence isMultifactorial
…..so what about the other 97.7% of patients who do run out of medications?
Used ItDidn’t Use
57% 43% Didn’t Know ??????
Patient education is a must! It’s our duty as physicians to explain medical conditions, treatment options, prognosis in terms that the patient can understand
Strategies for increasing adherence3: