Providers' Perspectives and Experiences with Cost-Related Nonadherence to Medications: A Thematic Analysis

Cost-related medication nonadherence (CRNA), whereby patients do not take medications as prescribed due to their cost, negatively affects health outcomes. While patients' experiences with CRNA have been characterized, studies have not explored providers' perspectives. Our objective was to explore the experiences and perspectives of providers caring for patients facing CRNA.

We conducted a qualitative research study involving one-on-one interviews with individuals 18 years or older and work as health or allied health professionals in Metro Vancouver from August 2023 to April 2024. Interviews were transcribed verbatim and thematic analysis was applied which involved: data familiarization (reviewing transcripts, cross-checking with audio for accuracy); initial coding (labelling concepts in the transcripts); and theme formation (grouping similar codes to capture broader experiences).

Altogether 16 providers participated (12 women, 3 men, 1 non-binary) from diverse disciplines. Thematic analysis led to three themes. The first theme, "how CRNA shapes practice" indicates that providers frequently deal with patients experiencing CRNA which is then associated with significant increases in workload. The second theme, "barriers to supporting patients through CRNA" suggests that most providers have no formal training to help them navigate CRNA and face time constraints in busy practices. The third theme, "making sense of CRNA within practice" highlights how providers conceptualize CRNA and how this then influences their responses to medication affordability challenges. Provider recommendations for addressing CRNA, included access to short-term funds, increased educational resources, and systemic organizational changes to increase provider supports.

CRNA affects not just patients, but also providers who care for them, revealing significant gaps in current systems of support. These insights underscore the need for coordinated policy action on medication affordability and the integration of structured resources within clinical settings to better equip providers to respond to CRNA.