Effect of format on comprehension of adherence data in chronic disease: A cross-sectional study in HIV

Abstract

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.

Prevalence of arterial hypertension and risk factors among people with acquired immunodeficiency syndrome

“…The patients’ schooling was relatively high, similar to the findings of other studies 20 - 21 . People with higher education level may have more access to relevant health information, presenting a broader perception on cardiovascular risk factors and the need to maintain a healthy lifestyle 22 .…”

Patient and clinician perspectives on optimizing graphical displays of longitudinal medication adherence data

“…Visual depiction of health information has gained increasing attention as a means for comprehensibly presenting complex data to patients. Accordingly, visualization of personal health data, including medication adherence, is a growing research area [13,[18][19][20][21][22][23][24]. Carefully developed graphical displays are particularly helpful to overcome low levels of literacy and numeracy that may initially impede patient comprehension of health data [25].…”