Medication Adherence: Gaining Insights on Patient-Reported Facilitators and Barriers

Abstract

Abstract Background: Evaluating patient-reported facilitators and barriers to medication adherence allows us to better understand patients' perceptions, which continue to be the root cause of medication nonadherence. Objective: This study aimed to assess patient-reported facilitators of and barriers to medication adherence. Methods: The principles of the concurrent method of triangulation were used for chronic disease patients aged ≥ 18 years who were hospitalized in a South Indian tertiary care teaching hospital. This six-month study used a semi-structured, pre-validated questionnaire for interviewing; responses were recorded to identify the reported facilitators and barriers. The patients were counselled, and the data collected were statistically analyzed categorically. Results: A total of 431 patients were enrolled, and the majority [223 (51.7%)] were non-adherent to the medication. The barriers included forgetfulness, attitudes, misbeliefs, lack of follow-up and refilling, lack of social support, financial constraints, lack of accessibility to healthcare, improper rapport with healthcare professionals, lack of disease knowledge, complex dosage regimens, and adverse effects. Facilitators included regular refills, good social support, good rapport with healthcare professionals, and good access to healthcare and routines. The older age group of 71-80 years [OR 3.18 (95% CI, 1.27–7.91)], annual income (INR) of 3-5 Lakhs [OR 6.75 (95% CI, 1.26–36.03)], two or more number of past medications [OR 2.85 (95% CI, 1.75–4.66)], number of current medications (during hospitalization) being 6-10 [OR 4.10 (95% CI, 1.07–15.71)], number of disease conditions more than 3 [OR 9.19 (95% CI, 2.02–41.64)] and management of discharge medications by others than self [OR 2.93 (95% CI, 1.10–7.77)] were found to be significant predisposing factors. Conclusions: This study provides a framework for research on medication non-adherence in patients with chronic disease by describing a set of predictors along with facilitators and barriers to medication adherence identified through patient-reported measures.