Individual patients hold different beliefs to prescription medications to which they persist vs nonpersist and persist vs nonfulfill

Colleen A McHorney, Abhijit S Gadkari

U.S. Outcomes Research, Merck and Co. Inc., North Wales, PA, USA

Objective: Our objective was to explore whether adults hold different beliefs about medications to which they persist vs nonpersist and persist vs nonfulfull.

Methods: We conducted a cross-sectional survey of adults with asthma, hypertension, diabetes, hyperlipidemia, osteoporosis, or other cardiovascular disease from the Harris Interactive Chronic Illness Panel. A quota was set to obtain a sample of respondents who were persistent to a medication for one disease and nonpersistent or nonfulfilling to a medication for a second, different disease. Respondents completed 32 items yielding five multi-item scales: perceived need for medication (k = 12), side-effect concerns (k = 5), medication-safety concerns (k = 5), perceived disease severity (k = 3), and knowledge about the prescribed medication (k = 7). Respondents completed the 32 items twice – once for their persistent medication and a second time for their nonpersistent or nonfulfilling medication. Paired sample t-tests (bivariate) and generalized estimating equations (GEE) models (multivariate) were used to test the study hypotheses.

Results: Overall, 178 respondents were sampled for being persistent to one medication and nonpersistent to another, while 48 respondents were persistent to one medication and nonfulfilling to a second. For the medication to which an individual patient was persistent vs nonpersistent, there was significantly higher perceived need, fewer side-effect concerns, higher perceived disease severity, and better knowledge about the medication. For the medication to which an individual patient was persistent vs nonfulfilling, there was significantly higher perceived need, fewer side-effect concerns, and better knowledge about the medication.

Conclusion: Individual patients hold different beliefs about medications to which they persist vs nonpersist or nonfulfill. Patients exhibit different medication-taking behaviors for different medications because they weigh the perceived risks and benefits for each medication separately. These results suggest that adherence interventions should be tailored to patients’ beliefs about specific medications.

Keywords: adherence, persistence with therapy, medication beliefs, chronic disease, primary nonadherence, medication nonfulfilment