New Study Reveals Key Factors Behind Medication Non-adherence: Patient Education and Distinctive Packaging Emerge as Potential Solutions

Recent research has identified critical factors behind medication non-adherence and explored potential remedies for patients in both metropolitan and nonmetropolitan areas. Financial constraints, forgetfulness, and inadequate patient counseling are the primary reasons for non-adherence, the new study has reported.

Notably, forgetfulness was the leading cause in urban areas, while financial challenges were more prevalent in rural regions, highlighting the need for region-specific interventions.

The findings have been published in the latest issue of Heart India, published by Wolters Kluwer.

Medication Non-Adherence: Unique Trends Across Regions

The study revealed a higher rate of non-adherence to secondary prevention measures among elderly or dependent individuals in nonmetropolitan cities, at 41.9%, compared to 35.1% in metropolitan areas. Conversely, non-education was linked to a higher rate of non-adherence in metropolitan areas (32.4%) compared to nonmetropolitan areas (26.7%).

Perception of Interventions to Improve Medication Adherence

Patients from metropolitan areas preferred patient education as the primary solution for improving adherence (58.1%), while those in nonmetropolitan areas favored both patient education (41.3%) and unique packaging differentiation (40.0%). Despite the low popularity of pill reminders (<10% preference across groups), a strong consensus emerged on using unique pack colors to boost adherence, with 96.4% of metropolitan and 98.4% of nonmetropolitan respondents supporting this approach.(1)

The study underscores the need for enhanced patient counseling and innovative strategies like color-coded packaging to address medication nonadherence effectively.

Medication Non-Adherence in Cardiac Patients: Pervasive Issue

Non-adherence to medications affects over 60% of cardiovascular patients, significantly increasing the risk of mortality, hospitalizations, and healthcare costs. Primary non-adherence, which involves not filling initial prescriptions, leads to a substantial rise in 1-year mortality following myocardial infarction. Secondary nonadherence, which involves failing to follow instructions or refill prescriptions, also contributes to higher mortality rates and increased healthcare expenses.(2)

A study by Pallangyo, Pedro et al. found that poor adherence is a strong predictor of early mortality in heart failure patients (HR 2.5, 95% CI 1.3-4.6, p<0.01).(3)

Medication adherence is positively correlated with health literacy (r = 0.36, p<0.0001) but negatively correlated with treatment burden (r = -0.22, p<0.0001), number of chronic conditions (r = -0.23, p<0.0001), and age (r = -0.11, p<0.05). This highlights the need for clinicians to address these factors to improve adherence among older adults with multiple chronic conditions.(4)

Given that nonadherence is driven by factors such as forgetfulness, polypharmacy, perceived ineffectiveness, age, comorbidities, and low health literacy, innovative solutions like color-coded strip packaging may improve adherence and clinical outcomes in cardiovascular diseases.

Reference:

1. Mahapatra C, Kenchappa K, Agarwal A, Revankar S. Understanding the reasons behind medication nonadherence and exploring potential solutions. Heart India 2024;12:131-2.

2. Baroletti, Steven, and Heather Dell'Orfano. “Medication adherence in cardiovascular disease.” Circulation vol. 121,12 (2010): 1455-8. doi:10.1161/CIRCULATIONAHA.109.904003

3. Pallangyo, Pedro et al. “Medication adherence and survival among hospitalized heart failure patients in a tertiary hospital in Tanzania: a prospective cohort study.” BMC research notes vol. 13,1 89. 21 Feb. 2020, doi:10.1186/s13104-020-04959-w

4. Selvakumar, Dharrshinee et al. “Relationship between Treatment Burden, Health Literacy, and Medication Adherence in Older Adults Coping with Multiple Chronic Conditions.” Medicina (Kaunas, Lithuania) vol. 59,8 1401. 31 Jul. 2023, doi:10.3390/medicina59081401