6.1 KiB
| title | chunk | source | category | tags | date_saved | instance |
|---|---|---|---|---|---|---|
| Adherence (medicine) | 2/5 | https://en.wikipedia.org/wiki/Adherence_(medicine) | reference | science, encyclopedia | 2026-05-05T07:25:48.247796+00:00 | kb-cron |
=== Literacy === In 1999 one fifth of UK adults, nearly seven million people, had problems with basic skills, especially functional literacy and functional numeracy, described as: "The ability to read, write and speak in English, and to use mathematics at a level necessary to function at work and in society in general." This made it impossible for them to effectively take medication, read labels, follow drug regimes, and find out more. In 2003, 20% of adults in the UK had a long-standing illness or disability and a national study for the UK Department of Health, found more than one-third of people with poor or very poor health had literary skills of Entry Level 3 or below. A study of the relationship of literacy to asthma knowledge revealed that only 31% of asthma patients with a reading level of a ten-year-old knew they needed to see the doctors, even when they were not having an asthma attack, compared to 90% with a high school graduate reading level.
=== Treatment cost === In 2013 the US National Community Pharmacists Association sampled for one month 1,020 Americans above age 40 for with an ongoing prescription to take medication for a chronic condition and gave a grade C+ on adherence. In 2009, this contributed to an estimated cost of $290 billion annually. In 2012, increase in patient medication cost share was found to be associated with low adherence to medication. The United States is among the countries with the highest prices of prescription drugs mainly attributed to the government's lack of negotiating lower prices with monopolies in the pharmaceutical industry especially with brand name drugs. In order to manage medication costs, many US patients on long term therapies fail to fill their prescription, skip or reduce doses. According to a Kaiser Family Foundation survey in 2015, about three quarters (73%) of the public think drug prices are unreasonable and blame pharmaceutical companies for setting prices so high. In the same report, half of the public reported that they are taking prescription drugs and a "quarter (25%) of those currently taking prescription medicine report they or a family member have not filled a prescription in the past 12 months due to cost, and 18 percent report cutting pills in half or skipping doses". In a 2009 comparison to Canada, only 8% of adults reported to have skipped their doses or not filling their prescriptions due to the cost of their prescribed medications.
=== Health literacy === Cost and poor understanding of the directions for the treatment, referred to as 'health literacy' have been known to be major barriers to treatment adherence. Misinformation from the internet and social media can also lead to a delay or lack of compliance in following medical advice.
=== Age === The recent National Service Framework on the care of older people highlighted the importance of taking and effectively managing medicines in the elderly. Elderly individuals may face challenges, including multiple medications with frequent dosing, and potentially decreased dexterity or cognitive functioning. Patient knowledge is also a factor. In 1999 Cline et al. identified several gaps in knowledge about medication in elderly patients discharged from hospital. Despite receiving written and verbal information, 27% of older people discharged after heart failure were classed as non-adherent within 30 days. Half the patients surveyed could not recall the dose of the medication that they were prescribed and nearly two-thirds did not know what time of day to take them. A 2001 study by Barat et al. evaluated the medical knowledge and factors of adherence in a population of 75-year-olds living at home. They found that 40% of elderly patients do not know the purpose of their regimen and only 20% knew the consequences of non-adherence. Comprehension, polypharmacy, living arrangement, multiple doctors, and use of compliance aids was correlated with adherence. In children with asthma, self-management compliance is critical and co-morbidities have been noted to affect outcomes; in 2013 it has been suggested that electronic monitoring may help adherence.
=== Ethnicity === People of different ethnic backgrounds have unique adherence issues through, for example, limited English language proficiency, their cultural belief system rooted in historical experience (Tuskegee experiment), resulting in medical mistrust. There are few published studies on adherence in medicine taking in ethnic minority communities. Ethnicity and culture influence some health-determining behaviour, such as participation in health screening programmes and attendance at follow-up appointments. Ethnic groups differ in their attitudes, values, culture and beliefs about health and illness, particularly with preventive treatments and medication for asymptomatic conditions. Additionally, some cultures fatalistically attribute their good or poor health to their god(s), and attach less importance to self-care than others. Complementary and alternative medicine may be taken with or instead of the prescribed medications especially in Mexican American and Vietnamese people. Studies have shown that black patients and those with non-private insurance are more likely to be labeled as non-adherent. An increased risk for non adherence was observed even after controlling for A1c, and socioeconomic factors.
=== Prescription fill rates === Not all patients will fill the prescription at a pharmacy. In a 2010 U.S. study, 20–30% of prescriptions were never filled at the pharmacy. Reasons people do not fill prescriptions include the cost of the medication, A US nationwide survey of 1,010 adults in 2001 found that 22% chose not to fill prescriptions because of the price, which is similar to the 20–30% overall rate of unfilled prescriptions. Other factors are doubting the need for medication, or preference for self-care measures other than medication. Convenience, side effects and lack of demonstrated benefit are also factors.