Staying Informed to Stay on Medication

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Poor medication adherence linked to limited ability to comprehend health information

August 29, 2013 / Author:  / Reviewed by: Joseph V. Madia, MD Beth Bolt, RPh

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(dailyRx News) Understanding basic health information — in other words, health literacy — can help patients make the right health decisions and take their medications correctly.

But some people may have trouble grasping such information and adhering to their prescribed medication regimens.

A new study found that low health literacy was associated with poor adherence to antidepressant medication among diabetes patients. According to the study, this may result in poor self-care which can lead to complications of diabetes.

The study's authors wrote that these findings highlight the importance of improving health literacy and simplifying information about treatment options.

"Take your medication as prescribed."

This study was conducted by Amy M. Bauer, MD, MS, from the Department of Psychiatry and Behavioral Sciences at the University of Washington School of Medicine in Seattle.

The aim of the study was to find out whether lower patient health literacy was associated with poor adherence to antidepressant medication.

The researchers looked at 1,366 adults with type 2 diabetes who were prescribed antidepressants between 2006 and 2010.

The patients answered a survey that measured health literacy on a 15-point scale by asking questions that estimated their ability to comprehend health information.

Patients who received a score of 15 were considered to have no health literacy limitations. Patients who scored between 0 and 14 points were deemed to have health literacy limitations.

Adherence to medication was measured using pharmacy dispensing data that indicated which patients had not adhered to their prescriptions.

The researchers looked at three different rates of non-adherence, including primary non-adherence (medication never purchased), early non-persistence (purchased once but never refilled medication) and non-persistence at 180 and 365 days.

They also calculated the new prescription medication gap (proportion of time the patient doesn’t have medication during 12 months following the prescription date).

The higher these rates, the poorer the adherence.

Health literacy limitations were observed in 72 percent of the patients in this study.

Patients with health literacy limitations had higher non-persistence rates (46 percent) as compared to patients with no health literacy limitations (38 percent).

Non-persistence at 180 days was also higher in patients with health literacy limitations (55 percent) versus patients with no health literacy limitations (46 percent).

Patients with health literacy limitations also had a higher new prescription medication gap (41 percent) as compared to patients with no literacy limitations (38 percent).

Overall, patients with health literacy limitations had significantly poorer adherence to medication as compared with those with no limitations.

"Patient compliance and adherence are an everyday struggle that we as pharmacists take very seriously. It is vital that patients understand the importance of following instructions and speaking up if he/she doesn't comprehend any bit of information regarding their prescriptions," Brad Delaney, PharmD, a pharmacist at Tarrytown Pharmacy in Austin, Texas, told dailyRx News.

“Findings underscore the importance of national efforts to address health literacy, simplify health communications regarding treatment options, improve public understanding of depression treatment, and monitor antidepressant adherence,” wrote the authors in the study conclusion.

The results of this study were published in the September issue of the Journal of General Internal Medicine.

The study was funded by grants from the National Institutes of Health. One of the study authors disclosed receiving honoraria from Pfizer, Forest and Eli Lilly. The other authors did not disclose any conflicts of interest.