Medication adherence in a nurse practitioner managed clinic for indigent patients

Abstract

Purpose Little is published in the literature about medication adherence rates among patients who are medically indigent and patients receiving primary care from nurse practitioners (NPs). This project examined adherence rates and barriers to adherence among patients at an NP‐managed health clinic (NPMC). Data sources The setting for this research was an NPMC for uninsured and low‐income patients. A cross‐sectional convenience sample of patients (n = 119) completed surveys eliciting demographic information, self‐report of medication adherence, health literacy, and barriers to adherence. Conclusions Analysis of subjects demonstrated a vulnerable population, yet the mean adherence rate was surprisingly high (77%), compared to the rate usually cited in published literature. The best predictive model differentiating patients with high adherence from those with low adherence combined the total number of reported barriers, health literacy, and employment status. The barriers most frequently cited by subjects were difficulty paying for medications, and difficulty reading and understanding written prescription labels, which was particularly prevalent among Spanish‐speaking patients. Implications for practice Clinic efforts to improve patient access to affordable medications may have contributed to subjects’ high rates of adherence. These efforts included helping patients with filling out prescription assistance program paperwork, prescribing generic medications, providing samples, and providing effective patient education.

Evaluation of medication adherence in chronic disease at a federally qualified health center

“…In fact, the inverse is usually observed. 14,22 We conjecture that having a majority of Spanish-speaking providers within our clinics may have promoted adherence among our Spanish-speaking patients.…”

“…In regards to the secondary outcomes, many studies in the past utilized self-reporting questionnaires and surveys to measure adherence. 14, 27–30 Thus, it is difficult to make direct comparisons with the previous literature when assessing individual patient factors associated with adherence. Even in the available studies using MPR or PDC as measures of adherence, there have been conflicting results of whether men or women are less adherent to their medications.…”

“…There are limited data evaluating medication adherence within the Medicaid recipient population and even less in the setting of an FQHC. 14 Thus, this study was conducted to evaluate medication adherence in Medicaid recipients receiving care within an FQHC.…”

A narrative review on do’s and don’ts in prescription label writing – lessons for pharmacists

“…Consequently, patients may find it difficult to read, understand or even recall the information provided. 9 The level of understanding of prescription label instructions vary, and ranged from 53% to 89% in some studies conducted in the USA. 10 It is also known that poor readability significantly affects comprehensibility and medication recall.…”