Frequency of and reasons for medication non‐fulfillment and non‐persistence among American adults with chronic disease in 2008

摘要

Objective To identify self‐reported reasons why adults with chronic disease do not fill a new prescription (medication non‐fulfillment) and/or stop taking a medication without their physician telling them to do so (lack of medication persistence). Methods Participants were sampled in 2008 from a national, internet‐based panel of American adults with chronic disease. A total of 19 830 respondents answered questions about medication non‐fulfillment and medication non‐persistence and reasons for non‐fulfillment and non‐persistence. Among persons self‐identified as non‐fulfillers and non‐persisters, statistical analyses assessed the association between reported reasons for non‐fulfillment and non‐persistence and chronic disease. A subsample of respondents completed an additional survey which included multi‐item scales assessing matched constructs of most of the reasons for non‐fulfillment and non‐persistence. The convergent validity of the self‐reported reasons was assessed against the multi‐item scales. Results The same four reasons were most commonly reported for both medication non‐fulfillment and medication non‐persistence: paying for the medication a financial hardship (56 and 43%, respectively); fear or experience of side effects (46 and 35%, respectively); generic concerns about medications (32 and 23%, respectively); and lack of perceived need for the medication (25 and 23%, respectively). The frequency with which the reasons were reported varied somewhat by chronic disease. The convergent validity of most of the self‐reported reasons was confirmed against multi‐item scales measuring matched constructs. Conclusions The same top reasons for medication non‐fulfillment and non‐adherence were observed in a large internet‐based sample of American adults with chronic disease. Future efforts to improve medication adherence should address patients’ medication concerns, perceived need for medications, and perceived medication affordability.