Medication nonadherence, e.g. patients
not taking medication as prescribed or discontinuing before they finish
the course, has been shown to seriously hurt health outcomes in
One of the reasons for this may be financial barriers. Now, a new study published in ClinicoEconomics and Outcomes Research
examines this further.
‘While the overall level of poor adherence due to costs is limited, cost-related barriers to medication adherence appear to be concentrated among the most cognitively- and socioeconomically vulnerable patients.’
A research team from Massachusetts General Hospital set out to
capture more accurate, specific and informative date on medication
nonadherence in neurology in a study entitled "Patient-reported
financial barriers to adherence to treatment in neurology."
The US team
collected cross-sectional survey responses using an iPad as part of
routine outpatient care in a neurology clinic over a three-month period.
They merged this data with administrative sources of demographic and
clinical information, insurance details for example, to form a fuller
picture of how often and what the financial barriers to patients who
fail to refill prescription medication.
Almost 3,000 adults who came to the clinic between July and September
2015 participated in the survey. The mean age of participants was 56
years, and 54% were female. Participants were comparable to
nonparticipants with respect to gender and ethnicity but more often
identified English as their preferred language. 265 respondents (9.8%) reported nonadherence that
varied by condition. These patients were more frequently Hispanic,
living alone, and preferred a language other than English.
The study found that the magnitude of financial barriers to
medication adherence appears to vary across neurological conditions and
Corresponding author of the study, Dr Lidia Moura, said "Our results
suggest that one in ten of our patients with neurological problems have
reported financial barriers to medication adherence. These findings are
consistent with previous studies that found that trouble affording
medications was the fourth leading reason for medication nonadherence
among elderly patients. The study offers opportunities to improve
outcomes in neurology patients through medication adherence and drive
health policy in neurology."
She continued, "The study also suggests that while the overall level
of poor adherence due to costs is limited, cost-related barriers to
medication adherence appear to be concentrated among the most
cognitively- and socioeconomically vulnerable patients. Multiple
strategies are needed to prospectively identify these vulnerable
patients and to alter prescribing practices to enhance affordability and
thereby long-term efficacy."