Patients who trust their doctors are more likely to take their medications regularly than patients who do not have so much trust in their medical caregivers or are suffering from depressions.
Those findings, from a new study of 912 patients with diabetes, provide evidence that the quality of the doctor-patient relationship can greatly affect patients' medication use when drug costs become a burden. The study reinforces the importance of the doctor-patient relationship in helping patients adhere to medicines, and has implications for how doctors talk with patients — not only about what a medicine will do for them, but also about their ability to pay for it and the availability of lower-cost options.
The research, from the scientists at the University of Michigan, will be published in the August issue of the Archives of Internal Medicine. The data are from a larger VA-funded study of diabetes care at five health care systems around the nation.
The researchers said that the results provide insights into how cost, trust, mental health and income interact to influence patient behaviors toward prescription medications.
In all, nearly 30 percent of people who reported low levels of trust in their doctors and had monthly drug costs over $100 said they skipped medicines due to cost, compared with 11 percent of those who had a more trusting relationship with their doctor and the same level of cost. Among people with incomes under $10,000, cost affected adherence to drugs only among those with low physician trust.
Patients who reported experiencing symptoms of depression on a standardized scale were twice as likely to skip medicines due to cost as patients without depression. And patients who reported problems taking medications for other reasons were much more likely to report that they had cut back on medicine use due to cost.
Research has shown that skipping medications due to cost can seriously affect a person's health. That's especially true for people with chronic diseases. The patients in the current study had diabetes, and 41 percent of them used insulin. People with diabetes who fail to take their medication as prescribed may have poor blood sugar control and a higher risk of heart attacks, strokes, blindness, kidney failure and amputation.