Patients' problems with new medication for chronic conditions

Nicholas Barber

BMJ Quality & Safety · 2004 · 214 citations · 9 references

DOIFull text

Open access

Concepts

TL;DR

The study aimed to evaluate adherence, intentionality of non‑adherence, medication problems, and information needs among patients starting new chronic medications. A longitudinal survey of 258 patients from 23 community pharmacies in southeast England collected data at 10 days and 4 weeks via telephone interviews and postal questionnaires, focusing on those starting new chronic medications and meeting age or disease criteria. Within weeks of starting new chronic medication, 30 % were non‑adherent at 10 days and 25 % at 4 weeks, with over half of non‑adherence being unintentional; two‑thirds of adherent patients reported medication problems and more than half expressed a need for additional information, indicating a rapid and substantial unmet support requirement.

Abstract

To assess patients' adherence to new medication for a chronic condition (and whether non-adherence was intentional), patients' problems with their medication, and their further information needs.A longitudinal survey with data collection at 10 days and 4 weeks was performed on 258 patients recruited from 23 community pharmacies in south east England. Patients were eligible to participate if they were starting a new chronic medication and were either 75 years or older or had one of the following chronic conditions: stroke, coronary heart disease, asthma, diabetes, and rheumatoid arthritis. At each time point a semi-structured telephone interview was conducted and a postal questionnaire was sent.Self-reported adherence, causes of non-adherence, problems with medication, information needs.Sixty seven (30%) of 226 patients still taking their medication at 10 days and 43 of 171 (25%) still taking their medication at 4 weeks were non-adherent. At 10 days 55% of the non-adherence was unintentional and the remainder was intentional; these proportions were similar at 4 weeks. 138 of 208 (66%) participants still taking their new medication at 10 days reported at least one problem with it. 137 of 226 patients (61%) expressed a substantial and sustained need for further information at 10 days and 88 of 171 (51%) at 4 weeks. Several patients who were adherent or reported no problems at 10 days were non-adherent or had problems at 4 weeks.A significant proportion of patients newly started on a chronic medication quickly become non-adherent, often intentionally so. Many have problems with their medication and information needs. Patients need more support when starting on new medication for a chronic condition and new services may be required to provide this.

References

9