Predictors of Medication-Refill Adherence in an Indigent Rural Population

OBJECTIVE: We evaluated the association of medication refill adherence with demographic and prescription characteristics to determine whether such factors could guide intervention strategies in an indigent rural population. METHODS: The study was conducted at a University-based internal medicine practice serving an indigent rural population. Refill data for diabetes, hypertension, and hypercholesterolemia drugs from a closed pharmacy system were used to calculate mean adherence (for all drugs taken by each patient) and minimum adherence (that of the least adhered to drug) for 1984 patients during a 9-month period. RESULTS: Mean refill adherence was <80% for 33% of the population and minimum refill adherence was <80% for 55% of the patients. Increasing age, race (white), and prescription length were associated with higher mean and minimum adherence, independent of income, prescription copay, and insurance status. Number of drugs taken had a positive mean but negative minimum adherence association. Gender, number of primary care visits, and dosage schedule were not independently associated with adherence. The model explained 6.8% of the variance in mean adherence. CONCLUSIONS: In a rural indigent population, medication refill adherence was associated with race, age, and prescription length, though these factors explained only a small amount of adherence variability. Although ingestion adherence is the goal, refill adherence is a necessary condition for ingestion adherence. To enhance adherence, physicians need better predictors to target their efforts to patients most in need of attention. Prescription claims data could serve this purpose

Environmental health · Family medicine · Intervention (counseling) · Medical prescription · Population · Psychiatry · Rural area · Medication Adherence and Compliance · Medicine · Mobile Health and mHealth Applications · Pharmaceutical Practices and Patient Outcomes · Pharmacy

• Using Quantile Regression to Assess Disparities in Medication Adherence

  Deborah Taira Juarez, Candace Tan et al.•American Journal of Health Behavior•2013

  Incluir item

• Use of the SF-8 to assess health-related quality of life for a chronically ill, low-income population participating in the Central Louisiana Medication Access Program (CMAP)

  Open Access•John J Lefante, Gary N Harmon et al.•Quality of Life Research•2005

  Incluir item

• Delineation of health care deserts using accessibility measures

  Piotr Rosik, Marcin Stępniak et al.•European Planning Studies•2021

  Incluir item

• Adherence to Chronic Disease Medications among New York City Medicaid Participants

  Open Access•Kelly A Kyanko, Robert H Franklin et al.•Journal of Urban Health•2012

  Incluir item

• Perceived Social Standing, Medication Nonadherence, and Systolic Blood Pressure in the Rural South

  Open Access•Doyle M Cummings, Jia‐Rong Wu et al.•The Journal of Rural Health•2016

  Incluir item

• Two Pharmacy Interventions to Improve Refill Persistence for Chronic Disease Medications

  Paul J Nietert, Barbara C Tilley et al.•Medical Care•2009

  Incluir item

• The assessment of refill compliance using pharmacy records

  Open Access•J F Steiner, Allan V Prochazka•Journal of Clinical Epidemiology•1997

  Incluir item

• Race, Gender, and Partnership in the Patient-Physician Relationship

  Lisa Cooper-Patrick•JAMA•1999

  Incluir item

• Attitudes about Racism, Medical Mistrust, and Satisfaction with Care among African American and White Cardiac Patients

  Open Access•Thomas A Laveist, Kim J Nickerson et al.•Medical Care Research and Review•2000

  Incluir item

• Inequality in Quality

  Kevin Fiscella, Peter Franks et al.•JAMA•2000

  Incluir item

• Can Cultural Competency Reduce Racial and Ethnic Health Disparities? A Review and Conceptual Model

  Open Access•Cindy Brach, Irene Fraserirector•Medical Care Research and Review•2000

  Incluir item

• Racial and Ethnic Disparities in Perceptions of Physician Style and Trust

  Mark P Doescher•Archives of Family Medicine•2000

  Incluir item

• Racial and Ethnic Differences in Disease

  W C Cockerham, Anthony P Polednak•Contemporary Sociology A Journal…•1990

  Incluir item

• Treatment for glaucoma

  Jerry H Gurwitz, Robert J Glynn et al.•American Journal of Public Health•1993

  Incluir item

• Correlates of nonadherence to hypertension treatment in an inner-city minority population

  Sarah Shea, Dawn P Misra et al.•American Journal of Public Health•1992

  Incluir item

• Compliance with antihypertensive therapy among elderly Medicaid enrollees

  Mark Monane, Rhonda L Bohn et al.•American Journal of Public Health•1996

  Incluir item

• Skepticism Toward Medical Care and Health Care Utilization

  Kevin Fiscella, Peter Franks et al.•Medical Care•1998

  Incluir item

• Validation of Patient Reports, Automated Pharmacy Records, and Pill Counts With Electronic Monitoring of Adherence to Antihypertensive Therapy

  Peter W Choo, Cynthia S Rand et al.•Medical Care•1999

  Incluir item

• Assessing Compliance to Antihypertensive Medications Using Computer-Based Pharmacy Records

  Dale B Christensen, Barbara Williams et al.•Medical Care•1997

  Incluir item

• The effects of health and treatment perceptions on the use of prescribed medication and home remedies among African American and white American hypertensives

  Open Access•Carolyn M Brown, Richard Segal•Social Science & Medicine•1996

  Incluir item