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Patient Educ Couns. 2010 Nov;81(2):177-81. doi: 10.1016/j.pec.2010.04.030. Epub 2010 Jun 1.

Association of age, health literacy, and medication management strategies with cardiovascular medication adherence.

Author information

1
Section of Hospital Medicine, Division of General Internal Medicine and Public Health, Department of Medicine, Vanderbilt University, Nashville, TN 37232, USA. sunil.kripalani@vanderbilt.edu

Abstract

OBJECTIVE:

To examine patients' use of medication management strategies (e.g., reminders, pill boxes), and to determine how their use influences the relationship between patient characteristics and medication adherence.

METHODS:

Retrospective and cross-sectional study of 434 patients with coronary heart disease, examining both refill adherence and self-reported adherence.

RESULTS:

The most common strategy for managing refills was seeing a near empty pill bottle (89.9%), and for managing daily medications, it was associating medications with daily events (80.4%). Age<65 (OR = 1.7), as well as marginal (OR = 2.0) or inadequate health literacy (OR = 1.9), was independently associated with low refill adherence. Patients <65 also had lower self-reported adherence (OR = 1.8). Adjustment for use of medication management strategies did not substantially change these relationships. Reliance on reminders from friends or family to take medications, or waiting to refill a medicine only when the bottle was near empty, each were associated with 3-fold greater odds of non-adherence.

CONCLUSION:

Age <65 and marginal or inadequate health literacy were independently associated with medication non-adherence. Use of medication management strategies did not explain these relationships.

PRACTICE IMPLICATIONS:

The strategies which patients report using to assist with managing medication refills and daily medication use may be ineffective.

PMID:
20684870
DOI:
10.1016/j.pec.2010.04.030
[Indexed for MEDLINE]
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