Comparison of a medication adherence simulation in professional pharmacy students versus undergraduate students

Previous research at colleges and schools of pharmacy showed that simulation learning is an effective method to teach pharmacy students about the issues patients face when prescribed complicated medication regimens. The purpose of this analysis was to compare reported medication adherence rates, perceived barriers, and methods used to increase adherence between undergraduate students and pharmacy students based on a medication-taking simulation course activity.

In spring semesters 2014 and 2015, students in both a pharmacy course and an undergraduate seminar course participated in a short simulation involving a complicated medication regimen. Within one week of participating in the simulation activity, the students answered survey questions about the assignment through an online course sharing platform.

Almost all students enrolled in the courses (237/246 pharmacy students and 34/36 undergraduate students) completed the assignment (> 96% response rate). A large percentage of each group reported some non-adherence; 95% (225/237) of first-year pharmacy students and 82% (28/34) of undergraduate students. The top two barriers reported were 1) simply forgetting and 2) difficulty following the food- and/or alcohol-related restrictions associated with some of the simulated medications. The top two methods used to increase adherence were phone/electronic reminders and paper/spreadsheet reminders.

A limitation to this study was the small sample size of undergraduate students. Even though the response rate was over 96%, the course was a small seminar-type course. Although it might be expected that pharmacy students would be more adherent since they may have had experience with non-adherence issues while working in a pharmacy, opposite results were found. Since the students were relatively young, most had not personally dealt with a complicated medication regimen.

Pharmacy students reported lower adherence to a complicated medication regimen than undergraduate students. The most common reasons for non-adherence and most common methods used to increase adherence were similar between the two cohorts. The use of electronic reminders was common for both groups of students, and should be included in discussions about methods to improve adherence rates.