Objective
To determine which formats communicate medication adherence effectively to patients.
Methods
HIV-infected adults on antiretrovirals viewed examples of refill data in 5 formats: (1) percentage of doses, (2) number of days late to refill (“days late”), (3) calendar of days with/without medications, (4) pie chart of days with/without medications, and (5) letter grade. Five scenarios (>95%, 90–95%, 80–90%, 70–80% and <70% adherence) were presented in each format. Participants rated scenarios on adherence improvement needed. “Good understanding” was ≥4 of 5 scenarios correct. We calculated odds ratios for “good understanding” using logistic regression with percentage as the referent format.
Results
124 participants were median age 48.5, 65% Black, 71% male. Understanding of all formats differed by education (all interaction p values<0.02). For ≤12 years education, odds ratios (OR) of understanding (95% CI) compared to percentage were: days late 3.3 (2.3–4.7), calendar 3.1 (2.2–4.3) pie chart 2.0 (1.4–2.7), and letter grade 1.8 (1.3–2.5) For >12 years education, ORs were: days late 1.3 (0.9–2.0), calendar 2.4 (1.5–3.8), pie chart 2.9 (1.8–4.6), and letter grade 1.7 (1.1–2.6). Calendar plot was most preferred.
Conclusions
Adherence percentage was the least understood format regardless of education.
Practice Implications
Calendars should be used to convey adherence information.
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