Association of age, health literacy, and medication management strategies with cardiovascular medication adherence

作者：Kripalani Sunil^*; Gatti Margaret E; Jacobson Terry A

来源：Patient Education and Counseling, 2010, 81(2): 177-181.

DOI：10.1016/j.pec.2010.04.030

• Physician-patient communication
• Health literacy
• Medication adherence

Objective: To examine patients' use of medication management strategies (e.g., reminders, pill boxes), and to determine how their use influences the relationship between patient characteristics and medication adherence.
Methods: Retrospective and cross-sectional study of 434 patients with coronary heart disease, examining both refill adherence and self-reported adherence.
Results: The most common strategy for managing refills was seeing a near empty pill bottle (89.9%), and for managing daily medications, it was associating medications with daily events (80.4%). Age <65 (OR = 1.7), as well as marginal (OR = 2.0) or inadequate health literacy (OR = 1.9), was independently associated with low refill adherence. Patients <65 also had lower self-reported adherence (OR = 1.8). Adjustment for use of medication management strategies did not substantially change these relationships. Reliance on reminders from friends or family to take medications, or waiting to refill a medicine only when the bottle was near empty, each were associated with 3-fold greater odds of non-adherence.
Conclusion: Age <65 and marginal or inadequate health literacy were independently associated with medication non-adherence. Use of medication management strategies did not explain these relationships.
Practice implications: The strategies which patients report using to assist with managing medication refills and daily medication use may be ineffective.

• 出版日期2010-11