Measurement, Correlates, and Health Outcomes of Medication Adherence Among           Seniors

Vik, Shelly; Maxwell, Colleen J.; Hogan, David B.

doi:10.1345/aph.1d252

Cited by 334 publications

(329 citation statements)

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“…Future research should determine whether gender norms explain sex differences in other stages of health service usage, including symptom awareness (14) and treatment adherence (59). Research should also continue to explore the role of the toughness norm in women’s behavior, especially in relation to treatment-seeking behavior.…”

Section: Discussionmentioning

confidence: 99%

Role of the Gender-Linked Norm of Toughness in the Decision to Engage in Treatment for Depression

O'Loughlin

Duberstein

Bell

et al. 2011

Psychiatric Services

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Objective Given their prevalence and persuasive power in our culture, gender norms— commonly described as socially reinforced, learned expectations of what it means to be a man or a woman—likely contribute to sex differences in service utilization for depression. This study investigated whether sex differences in toughness, a gender-linked norm characterized by a desire to hide pain and maintain independence, were associated with a preference to wait for depression to resolve on its own without active professional treatment (``wait-and-see” approach). Methods Participants (N=1,051) in the California Behavioral Risk Factor Surveillance System (BRFSS) survey were contacted in a follow-on survey to assess toughness, the kind of treatment they would prefer were they to receive a diagnosis of depression, and current symptoms of depression. Participants who reported ever having been diagnosed as having a depressive disorder on the BRFSS were oversampled threefold. Analyses were conducted using linear and logistic regressions. Results Men and women who scored higher on toughness had a greater preference for the wait-and-see approach (OR=1.14, p<.01). Women were less likely to prefer the wait-and-see approach (OR=.58, p<.04) and scored lower on toughness (B=−.70, p<.01). Men’s greater levels of toughness partially mediated the sex difference in treatment preferences (OR=.91, p<.05). Conclusions Men’s greater adherence to the toughness norm explained part of the sex difference observed in treatment-seeking preferences, but toughness undermined women’s treatment seeking as well. Findings could be used to inform novel public health communications intended to attract both men and women to psychiatric services.

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Section: Discussionmentioning

confidence: 99%

Role of the Gender-Linked Norm of Toughness in the Decision to Engage in Treatment for Depression

O'Loughlin

Duberstein

Bell

et al. 2011

Psychiatric Services

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“…7,8 Vulnerable groups such as racial minorities and the elderly have a higher risk of poor adherence. 5,6,9,10 In the case of antiplateletet medications, blacks are more likely to not receive a clopidogrel prescription 11 or to not fill it after PCI. Further, our prior analyses of insurer claims data showed that minority populations were less adherent to antiplatelet medications post drug-eluting stent (DES) placement.…”

mentioning

confidence: 99%

Can Phone-Based Motivational Interviewing Improve Medication Adherence to Antiplatelet Medications After a Coronary Stent Among Racial Minorities? A Randomized Trial

et al. 2014

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BACKGROUND:Minorities have lower adherence to cardiovascular medications and have worst cardiovascular outcomes post coronary stent placement OBJECTIVE: The aim of this study is to compare the efficacy of phone-delivered Motivational Interviewing (MINT) to an educational video at improving adherence to antiplatelet medications among insured minorities. DESIGN: This was a randomized study. PARTICIPANTS: We identified minorities with a recently placed coronary stent from an administrative data set by using a previously validated algorithm. INTERVENTIONS: MINT subjects received quarterly phone calls and the DVD group received a one-time mailed video. MAIN MEASURES: Outcome variables were collected at baseline and at 12-month post-stent, using surveys and administrative data. The primary outcome was antiplatelet (clopidogrel and prasugrel) adherence measured by Medication Possession Ratio (MPR) and self-reported adherence (Morisky score). We also measured appropriate adherence defined as an MPR ≥ 0.80. KEY RESULTS: We recruited 452 minority subjects with a new coronary stent (44 % Hispanics and 56 % Black). The patients had a mean age of 69.5±8.8, 58 % were males, 78 % had an income lower than $30,000 per year and only 22 % had achieved high school education or higher. The MPR for antiplatelet medications was 0.77 for the MINT group compared to 0.70 for the DVD group (p<0.05). The percentage of subjects with adequate adherence to their antiplatelet medication was 64 % in the MINT group and 50 % in the DVD group (p<0.01). Self-reported adherence at 12 months was higher in the MINT group compared to the DVD group (p<0.01). Results were similar among drug-eluting stent (DES) recipients. CONCLUSIONS: Among racial minorities, a phone-based motivational interview is effective at improving adherence to antiplatelet medications post coronary stent placement. Phone-based MINT seems to be a promising and cost-effective strategy to modify risk behaviors among minority populations at high cardiovascular risk. BACKGROUNDThe safe use of coronary stents requires the daily use of thienopyridines for 3 to 12 months after percutaneous coronary intervention (PCI). 1 The premature discontinuation of these medications 1 is associated with an increased risk of instent thrombosis, cardiovascular events and death. 2-6 Unfortunately, lack of medication adherence is common and is associated with significant health care costs and mortality. 7,8 Vulnerable groups such as racial minorities and the elderly have a higher risk of poor adherence. 5,6,9,10 In the case of antiplateletet medications, blacks are more likely to not receive a clopidogrel prescription 11 or to not fill it after PCI. Further, our prior analyses of insurer claims data showed that minority populations were less adherent to antiplatelet medications post drug-eluting stent (DES) placement. 12 The lack of appropriate use of evidence-based therapies after PCI may partially contribute to the excess morbidity and mortality reported among minorities. 13,14,6 The improvement of med...

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“…97 Many variables have been studied to determine risk factors for drug nonadherence. These can be patient-and drug-related factors.…”

Section: Adherencementioning

confidence: 99%

“…The most commonly associated risk factors are increased age, male sex, psychological stress (depression), poor cognition, increased number of comorbidities (more than three), and lack of knowledge about health conditions and drug purpose. [97][98][99] Drug-related risk factors have been more consistent when predicting adherence. Increased number of prescription drugs, longer therapy duration, adverse drug effects, ease of the drug regimen (use of once-daily or sustained-release formulations), higher drug costs, and increased number of prescribers are risk factors of drug nonadherence.…”

Section: Adherencementioning

confidence: 99%

“…Increased number of prescription drugs, longer therapy duration, adverse drug effects, ease of the drug regimen (use of once-daily or sustained-release formulations), higher drug costs, and increased number of prescribers are risk factors of drug nonadherence. [97][98][99][100] Other reasons for nonadherence include forgetfulness, lack of disease symptoms, perceived ineffectiveness of drugs, and unclear directions for administration. 97 A multidisciplinary team that included a pharmacist improved drug adherence (measured by pill counts) up to 30 days after patient discharge from the hospital.…”

Section: Adherencementioning

confidence: 99%

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Pharmacy Practice, Research, Education, and Advocacy for Older Adults

et al. 2005

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In the United States, older adults have become the fastest growing segment of the population and are expected to double in number to 70 million by 2030. As a whole, older adults have different health care needs than younger patients, and some of these needs should be met by pharmacists. Clinical pharmacy practice affecting older adults occurs in a variety of settings, including community, ambulatory care, primary care, hospital, assisted living, nursing home, home health care, hospice, and Alzheimer's disease units. Although specialty training in geriatrics or gerontology is not required for pharmacists to care for older adults, it is extremely helpful. Pharmacy education related to the care of older adults has improved slightly in the past several years but will need to increase even more to provide all pharmacists with the basic skills and knowledge to care for this unique group of patients. In addition, pharmacotherapy research targeting older adults needs to increase. Although it can be challenging, funding for this type of research is available. Patient and political advocacy is also important to support this growing population.

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Measurement, Correlates, and Health Outcomes of Medication Adherence Among Seniors

Cited by 334 publications

References 100 publications

Role of the Gender-Linked Norm of Toughness in the Decision to Engage in Treatment for Depression

Role of the Gender-Linked Norm of Toughness in the Decision to Engage in Treatment for Depression

Can Phone-Based Motivational Interviewing Improve Medication Adherence to Antiplatelet Medications After a Coronary Stent Among Racial Minorities? A Randomized Trial

Pharmacy Practice, Research, Education, and Advocacy for Older Adults

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