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Refractory primary medication nonadherence: Prevalence and predictors after pharmacist counseling at hospital discharge
Author(s) -
Wooldridge Kathleene,
Schnipper Jeffrey L.,
Goggins Kathryn,
Dittus Robert S.,
Kripalani Sunil
Publication year - 2016
Publication title -
journal of hospital medicine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.128
H-Index - 65
eISSN - 1553-5606
pISSN - 1553-5592
DOI - 10.1002/jhm.2446
Subject(s) - medicine , polypharmacy , medical prescription , odds ratio , confidence interval , pharmacist , randomized controlled trial , emergency medicine , physical therapy , family medicine , pharmacy , nursing
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 of Hospital Medicine 2016;11:48–51. © 2015 Society of Hospital Medicine