Summaries of Must-Read Clinical Literature, Guidelines, and FDA Actions
Do Patient Beliefs Impact Medication Adherence?
J Am Board Fam Med; 2017 May/Jun; Gagnon, et al
Negative beliefs among patients about medications are as prevalent as external barriers to accessing medicines; however, negative beliefs are more significantly associated with medication adherence than external barriers, a recent study found. The study sample included 343 participants in a community health center. Low adherence was examined by any external barrier and by higher negative beliefs. Researchers found:
- 54% of patients reported low adherence; 51% had at least 1 barrier to adherence, and 52% reported more negative beliefs about medications.
- When beliefs and barriers were examined together, patients with negative beliefs were 49% less likely to adhere than those with more positive beliefs.
- However, barriers showed no significant impact on adherence.
Citation:
Gagnon MD, Waltermaurer E, Martin A, Friedenson C, Gayle E, Hauser DL. Patient beliefs have a greater impact than barriers on medication adherence in a community health center. J Am Board Fam Med. 2017;30(3):331-336. doi:10.3122/jabfm.2017.03.160129.
Adherence to taking medications as prescribed is critical if medications are to work as well in real life as they do in randomized trials. Medications for diabetes, for instance, can only decrease micro and macro-vascular disease over time if they are actually used. However, only about 75% of prescribed diabetes medication doses are taken. Issues around adherence are complicated and simple reminders to take medication don’t seem to work.1 This article shows a surprising, but important result. The authors measured barriers to obtaining medications: cost, access to refills, and perceived side effects. Through a questionnaire, they also measured concerns about medicines and patients’ perceptions of the necessity of the medicines they take. Interestingly, patients’ beliefs about their medications had slightly more effect on their adherence than actual barriers to obtaining medications. These results do not discount the importance of barriers like cost, ease-of-use, and side effects, but do suggest that our discussions with patients may inform and influence patients’ understanding of their medication and may have very real effects on their decisions to take medications after they leave the office. —Neil Skolnik, MD