April 16, 2021
According to research presented at AMCP 2021, underserved patients with complex medication regimens had a better understanding of their medications and less confusion about these regimens when they were given proper instructions. The study authors, led by Alyza King, PharmD, and colleagues suggest that educational interventions with instructive information in written form are often beneficial for addressing barriers to adherence.
“Evidence suggests that medication nonadherence among the underserved populations with chronic illness is a major concern,” Dr King and colleagues wrote. “Poor adherence is associated with worse health outcomes and leads to health disparities in the medically underserved population.”
In order to identify barrier to adherence among underserved patients, the study team conducted a cross-sectional survey-based study from January through March 2020 among patients above 18 years of age. They assessed medicate barriers using five items that were comprised of a seven-point rating scale with one corresponding to "strong barrier" and seven corresponding to "not a barrier.” Further, they assessed barriers using Chi-Square Tests, and used multivariable logistic regression models to identify the predictors of adherence barriers.
The following were reported as the most frequently reported barriers:
- Confusion of the instructions (29.58%);
- Cost of medications (28.17%); and
- Confusion for patients with different medications (25.35%).
Similarly, the least reported barriers were:
- A Lack of time to pick up the medication (23.94%); and
- The inability to read the bottle (12.68%).
“Patients with a high school education or less were significantly more likely to be confused by the medication instruction as compared to patients with college education (OR 5.23; 95% CI 1.40-19.45),” they wrote.
Likewise, the research team found that patients with a high school education or less were also more likely to be confused with different medications (OR 5.15; 95% CI 1.32-19.99), compared to those with a college education.
“Patient educational attainment was significantly associated with ability to understand the instructions of their medications and confusion about complex medication regimen,” they concluded. “Health care professionals play a crucial role in improving patients health literacy by encouraging patient-provider communication and incorporating educational interventions.”
King A, Mohan A, Rayo-Ramirez G, et al. Assessing the barriers to medication adherence among underserved patients with chronic illness. Poster presented at: AMCP 2021, April 12-16, 2021; Virtual.