Document Detail


Frequency of and reasons for medication non-fulfillment and non-persistence among American adults with chronic disease in 2008.
MedLine Citation:
PMID:  20860775     Owner:  NLM     Status:  In-Data-Review    
Abstract/OtherAbstract:
Objective  To identify self-reported reasons why adults with chronic disease do not fill a new prescription (medication non-fulfillment) and/or stop taking a medication without their physician telling them to do so (lack of medication persistence). Methods  Participants were sampled in 2008 from a national, internet-based panel of American adults with chronic disease. A total of 19 830 respondents answered questions about medication non-fulfillment and medication non-persistence and reasons for non-fulfillment and non-persistence. Among persons self-identified as non-fulfillers and non-persisters, statistical analyses assessed the association between reported reasons for non-fulfillment and non-persistence and chronic disease. A subsample of respondents completed an additional survey which included multi-item scales assessing matched constructs of most of the reasons for non-fulfillment and non-persistence. The convergent validity of the self-reported reasons was assessed against the multi-item scales. Results  The same four reasons were most commonly reported for both medication non-fulfillment and medication non-persistence: paying for the medication a financial hardship (56 and 43%, respectively); fear or experience of side effects (46 and 35%, respectively); generic concerns about medications (32 and 23%, respectively); and lack of perceived need for the medication (25 and 23%, respectively). The frequency with which the reasons were reported varied somewhat by chronic disease. The convergent validity of most of the self-reported reasons was confirmed against multi-item scales measuring matched constructs. Conclusions  The same top reasons for medication non-fulfillment and non-adherence were observed in a large internet-based sample of American adults with chronic disease. Future efforts to improve medication adherence should address patients' medication concerns, perceived need for medications, and perceived medication affordability.
Authors:
Colleen A McHorney; Charles V Spain
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Publication Detail:
Type:  Journal Article     Date:  2010-09-23
Journal Detail:
Title:  Health expectations : an international journal of public participation in health care and health policy     Volume:  14     ISSN:  1369-7625     ISO Abbreviation:  Health Expect     Publication Date:  2011 Sep 
Date Detail:
Created Date:  2011-08-11     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9815926     Medline TA:  Health Expect     Country:  England    
Other Details:
Languages:  eng     Pagination:  307-20     Citation Subset:  IM    
Copyright Information:
© 2010 Blackwell Publishing Ltd.
Affiliation:
Senior Director Epidemiologist, US Outcomes Research, Merck & Co., Inc., North Wales, PA, USA.
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