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Purpose: The purpose of this prospective study was to describe the medication taking behaviors of a sample of patients from a teaching internal medicine clinic.
Methods: Patients were included if they were >18 and taking a medication for blood pressure as well as a cholesterol medication and/or a diabetes medication. Patients completed questionnaires including demographics and medication history. A clinical pharmacist determined a total number of barriers to medication taking for each patient. Correlations were examined between education level, total barrier count, number or medications, and measures of adherence (Morisky and ASK 20).
Results: Between May 2011 and March 2012, 66 patients were enrolled and baseline demographics were collected. Forty of the patients enrolled in the study (61%) had no insurance or state Medicaid, and only 4 (6%) patients included had private insurance. Five patients had not completed high school. Forty-eight (72%) listed their education level as completion of high school. The mean ASK20 score was 41.9±9.9 and Morisky score was 0.9 for their medication adherence. The average number of barriers to medication taking in this population was 4.6 (±2.1). There was a lack of correlation between the total barrier count (TBC) and the Morisky score (r2=0.23); however, there was a better correlation between the ASK 20 and the TBC (r2=0.76). During individual patient interviews, medication histories were verified. A summary of pharmacist interventions will be presented including correlations to questions in adherence questionaires.
Conclusion: Medically underserved populations have large number of reasons for poor adherence to medications. Providers should be aware of adherence barriers. The Morisky and ASK20 may be highly variable measures of adherence in an underserved population.