Treatment adherence
Is forgetting your pills really just an accident?
Open access · cc by · source: Europe PMC
Forgetting or running out of chronic medication was very common and was predicted by people's beliefs about needing and affording the drug, so it is not purely accidental.
Study at a glance
- Design
- Cross-sectional — Online survey of a chronic-illness panel; logistic regression and bootstrapped mediation analysis
- N
- N=24017 · 24,017 self-identified medication persisters from 51,774 screener completers
- Population
- US adults aged 40+ on medication for hypertension, hyperlipidemia, diabetes, asthma, osteoporosis or depression
- Outcome
- Self-reported unintentional non-adherence (forgetting, running out, carelessness) and intentional non-adherence over six months
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Key findings
70% reported at least one unintentional non-adherence behaviour, most often forgetting (62%), and about a third reported intentional non-adherence. Lower perceived need, more concerns and especially lower affordability predicted unintentional non-adherence; those in the lowest affordability quartile were 2.32 times more likely to report it than those in the highest. Younger people were more affected, and mediation analysis suggested beliefs influence intentional non-adherence partly through unintentional non-adherence.
Methodology
The authors surveyed adults aged 40 and over from an internet chronic-illness panel who said they were still taking a prescription medicine for one of six common conditions. Respondents reported whether, in the past six months, they had forgotten doses, run out, or been careless, and whether they had deliberately changed or skipped doses. They also rated their perceived need for the medicine, their concerns about it, and its affordability, and the researchers tested whether unintentional non-adherence links those beliefs to intentional non-adherence.
Limitations
The design is cross-sectional, so the proposed chain from beliefs to unintentional to intentional non-adherence is not established in time; the authors call for longitudinal confirmation. Adherence was self-reported as yes/no without frequency and was not checked against pharmacy records. The internet panel had a 29.5% contact rate and over-represented white, higher-income and more educated respondents.
How this study connects
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