BACKGROUND: Literature has shown many patients do not adhere to prescribed medications. To help understand factors related to medication adherence, we conducted a survey of adherent and non-adherent patients.
OBJECTIVE: To determine factors that serve as barriers and facilitators to medication adherence for patients with diabetes and asthma.
METHODS: We identified all members >18 years with at least two prescription fills for > 28 days’ supply from January 2007 March 2009. We focused on medications (n=128) to treat depression, hypertension, hyperlipidemia, diabetes, asthma/COPD, multiple sclerosis, cancer or osteoporosis. Diagnoses were identified by ICD-9 code and merged with pharmacy claims. Adherence was calculated by the Medication Possession Ratio at a threshold of 80%.We randomly selected 500 individuals with the two conditions with the poorest adherence to survey (asthma 32% and diabetes (51%), half of whom were adherent and half who were not. Using the ASK-20 questionnaire as our basis, we added questions about facilitators and barriers to adherence.
RESULTS: Approximately 30% of patients forget to take their medications, 16% run out of medication because they don’t refill in time, and 22% had taken a medication more or less than prescribed in the past month. Barriers most commonly noted were an irregular schedule (22%), having to take pills with food (13%), and being too busy to keep prescriptions filled (12%). Facilitators most frequently reported were taking medications at the same time daily (95%) and using a weekly pill reminder (47%). We are currently analyzing open-ended comments to identify additional barriers and facilitators. We will also conduct a subgroup analysis (e.g., by gender, age).
CONCLUSION AND IMPLICATIONS: Building routine into one’s medication-taking behavior appears to be a key factor to ensuring adherence. Finding ways to help patients in this effort remains an important consideration of the health plan. The findings of this study will help guide discussion within the health plan’s pharmacy administration team to assist patients in their efforts to adhere to the medication regimens prescribed and thus maximize the benefits of prescribed therapies.