Patients don’t follow directions. A Canadian study found nearly one-third of patients don’t take their medications as directed. This is news to me. I thought it would have been a much higher proportion that are medication nonadherent. Medscape medical news reports:
In a study that examined more than 200,000 patients and 91,000 unique prescriptions, overall nonadherence rates ranged from 13.7% for patients prescribed antidepressants to 30.3% for patients prescribed antihypertensive therapies.
Researchers found that for conditions with symptoms, nonadherence ranged from 13.7% to 17.5%. For asymptomatic conditions such as hypertension, nonadherence ranged from 21.2% to 30.3%. Nonadherence for lipid lowering drugs taken for asymptomatic cardiovascular disease was 15.2%. Presumable people were more concerned about their heart and more took their drugs.
One thing that perplexed the researchers was that they could not identify any specific predictors of who would be medication nonadherent. There were no demographic factors. Income was not a predictor because low-income patients were eligible for a Pharmacare program. Indeed, whether a condition was symptomatic was the only way to predict medication nonadherence. Researchers speculate that certain provider types or patient types may be involved but the study could not measure them.
One primary takeaway from the study was how common medication nonadherence is and that physicians often don’t follow up and ask about whether patients are taking or even filling prescriptions.
To read the full study see: Can Fam Physician. 2022;68:5520-527. Full text