Can one or two simple questions predict poor medication adherence?

Area of Science:

• Clinical Pharmacy
• Health Services Research
• Patient Adherence

Background:

• Poor adherence to evidence-based medications is a significant challenge in clinical practice.
• Identifying patients at high risk for non-adherence requires improved prognostic tools.

Purpose of the Study:

• To evaluate if a two-item patient activation status (PAS) measure can identify Medicare beneficiaries at risk for poor adherence to type 2 diabetes medications.
• To assess the relationship between PAS and medication adherence in a Medicare population.

Main Methods:

• Utilized data from the 2009 Medicare Current Beneficiary Survey.
• Assessed patient activation status (PAS) and medication adherence using proportion of days covered (PDC).
• Classified PAS into active, high effort, complacent, or passive categories based on patient confidence and medication list use.

Main Results:

• Overall, PAS had a small effect on medication adherence (3% lower PDC for complacent/passive vs. active/high effort).
• Interactions revealed specific subgroups with significantly poorer adherence: beneficiaries under 65 (PDC -11%), non-Hispanic black beneficiaries (PDC -13%), and morbidly obese beneficiaries (PDC -9%).

Conclusions:

• A simple question about bringing medication lists to doctor visits may help identify at-risk patient subgroups.
• Larger sample sizes are needed to validate and expand these findings on patient adherence prediction.