Refractory primary medication nonadherence: Prevalence and predictors after pharmacist counseling at hospital discharge.

Abstract:

:Successful secondary prevention of cardiovascular disease relies on medication therapy; thus, minimizing nonadherence is a focus for improving patient outcomes. Receipt of discharge medication counseling has been associated with improved drug knowledge and adherence. We evaluated the prevalence and predictors of postdischarge primary nonadherence (not filling new prescriptions) in patients who received discharge medication counseling by a pharmacist (ie, refractory to intervention) as part of a randomized controlled trial. Of 341 patients, 9.4% of patients did not fill all prescriptions after discharge. Patients who were living alone were more likely to not fill their medications compared to those who were married or cohabitating (odds ratio [OR]: 2.2, 95% confidence interval [CI]: 1.01-4.8, P = 0.047). Patients who were discharged with greater than 10 medications were also more likely to demonstrate primary nonadherence (OR: 2.3, 95% CI: 1.05-4.98, P = 0.036). Patients with lower income were less likely to fill prescriptions in univariate analysis (P = 0.04) but not multivariable analysis. Our study demonstrates that among patients hospitalized for acute cardiovascular events, primary medication nonadherence persisted despite discharge medication counseling. Targeted or multimodal approaches that address patient-specific barriers, such as cost, social isolation, and polypharmacy, in addition to discharge counseling, may further facilitate adherence.

journal_name

J Hosp Med

authors

Wooldridge K,Schnipper JL,Goggins K,Dittus RS,Kripalani S

doi

10.1002/jhm.2446

subject

Has Abstract

pub_date

2016-01-01 00:00:00

pages

48-51

issue

1

eissn

1553-5592

issn

1553-5606

journal_volume

11

pub_type

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