Physician–Patient Communication About Prescription Medication Nonadherence: A 50-state Study of America’s Seniors
- Ira B. WilsonAffiliated withTufts–New England Medical Center Email author
- , Cathy SchoenAffiliated withThe Commonwealth Fund
- , Patricia NeumanAffiliated withThe Henry J. Kaiser Family Foundation
- , Michelle Kitchman StrolloAffiliated withThe Henry J. Kaiser Family Foundation
- , William H. RogersAffiliated withTufts–New England Medical Center
- , Hong ChangAffiliated withTufts–New England Medical Center
- , Dana Gelb SafranAffiliated withTufts–New England Medical Center
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Understanding and improving the quality of medication management is particularly important in the context of the Medicare prescription drug benefit that took effect last January 2006.
To determine the prevalence of physician–patient dialogue about medication cost and medication adherence among elderly adults nationwide.
National stratified random sample of community-dwelling Medicare beneficiaries aged 65 and older.
Main Outcome Measures
Rates of physician–patient dialogue about nonadherence and cost-related medication switching.
Forty-one percent of seniors reported taking five or more prescription medications, and more than half has 2 or more prescribing physicians. Thirty-two percent overall and 24% of those with 3 or more chronic conditions reported not having talked with their doctor about all their different medicines in the last 12 months. Of seniors reporting skipping doses or stopping a medication because of side effects or perceived nonefficacy, 27% had not talked with a physician about it. Of those reporting cost-related nonadherence, 39% had not talked with a physician about it. Thirty-eight percent of those with cost-related nonadherence reported switching to a lower priced drug, and in a multivariable model, having had a discussion about drug cost was significantly associated with this switch (odds ratio [OR] 5.04, 95% confidence interval [CI] 4.28–5.93, P < .001).
We show that there is a communication gap between seniors and their physicians around prescription medications. This communication problem is an important quality and safety issue, and takes on added salience as physicians and patients confront new challenges associated with coverage under new Medicare prescription drug plans. Meeting these challenges will require that more attention be devoted to medication management during all clinical encounters.
Key wordsphysician–patient relations Medicare pharmaceutical services patient compliance
- Physician–Patient Communication About Prescription Medication Nonadherence: A 50-state Study of America’s Seniors
Journal of General Internal Medicine
Volume 22, Issue 1 , pp 6-12
- Cover Date
- Print ISSN
- Online ISSN
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- physician–patient relations
- pharmaceutical services
- patient compliance
- Industry Sectors
- Author Affiliations
- 1. Tufts–New England Medical Center, 750 Washington Street, Box 345, Boston, MA, 02111, USA
- 2. The Commonwealth Fund, New York, USA
- 3. The Henry J. Kaiser Family Foundation, Menlo Park, USA