1. Student and Community Perceptions on
Reasons for Medication Non-Adherence
Daraoun Mashrah, PharmD Candidate and Patricia Darbishire, PharmD
Purdue University College of Pharmacy, West Lafayette, IN
OBJECTIVE
RESULTS
The purpose of this project was to:
improve medication adherence to prescription medications.
understand the complexity of factors that contribute to medication non-adherence.
explore the differences in the perception of pharmacy students. with those of patients regarding non-adherence factors
Ranked order of significance
Patients
N=310
Students
N=286 1
Too many
Forget 2
Too expensive 3 4
Drink alcohol
Schedule too complex 5
Interferes with lifestyle
Don't understand importance 6
Difficult to swallow
Confusing dosing 7
Don't understand purpose 8
Difficult to open bottle 9
Poor instructions 10
Interferes with sex
No transportation 11
Physical condition 12
Vision / difficult to read
Vision/ difficult to read 13 14 15 16
BACKGROUND
Medication non-adherence is a national epidemic that results in a substantial increase in healthcare utilization and costs, poor health outcomes, and an overall decreased quality of life.
Identifying and understanding reasons for non-adherence leads to educational opportunities in didactic, laboratory, and experiential healthcare curricula.
A significant difference was found between patients’ and students’ reasons for medication non-adherence. (4.38, 3.42), t (15) = 5.11, p < .001, d =1.27, based on four years of data.
Patients and students were in agreement of the top three reasons for medication non-adherence.
Patients indicated the number one reason for non-adherence is too many medications, whereas students believe it is forgetfulness.
METHODS
286 pharmacy students and 310 patients participated in this experiential assignment
Patients with medication non-adherence were recruited voluntarily from Midwest community pharmacies by students.
Patient selection was based on evidence of non-adherence from medication profiles and voluntary participation in the assignment
Data was collected over a four-year period, resulting in two years of information on patient perceptions and two years on student perceptions
The researchers’ ranked the data and examined it in light of existing medication adherence literature, as well as in relationship to articles associated with student education on this topic
Patients stated:
Cost of medication and interference with aspects of lifestyle, such as sexual health and drinking alcohol, were significant issues
Students believed:
Confusion, dosing complexity and lack of understanding were the primary problems with most patients.
Physical disabilities and logistical issues such as transportation were ranked lowest among both groups
REFLECTION AND CONCLUSION
Through our literature search and project results we determined that many factors lead to medication non-adherence, and more importantly, that individual patient characteristics greatly impact these factors.
Students and patients differ in their perceptions of the importance of these reasons. Educating student practitioners on variations in beliefs and perspectives is key in improving medication adherence.
Adherence education should be transitional and strategically placed in the classroom, practice laboratories, and in experiential education. This will help ensure that training translates into clinical expertise.
This knowledge can be generalized for use at other colleges of pharmacy, as well as within other healthcare discipline curricula to help better educate future practitioners.