Faculty Collaboration Database

Demographic, socioeconomic, and psychological factors related to medication non-adherence among emergency department patients. J Emerg Med 2012 Nov;43(5):773-85

Date

05/26/2009

Pubmed ID

19464136

DOI

10.1016/j.jemermed.2009.04.008

Scopus ID

2-s2.0-84869087936 (requires institutional sign-in at Scopus site)   13 Citations

Abstract

BACKGROUND: Many Emergency Department (ED) visits are related to medication non-adherence; however, the contributing factors are poorly understood.

OBJECTIVES: To explore the relative contributions of demographic, socioeconomic, and psychological factors to medication non-adherence in an ED population.

METHODS: This was a cross-sectional analysis enrolling patients with one of three illnesses requiring chronic medication usage (hypertension, diabetes, or seizures). Trained research associates administered a 60-item survey that assessed demographic and socioeconomic information, as well as a variety of psychological factors potentially relevant to adherence (health attitudes, health beliefs, depression, anxiety, social support, and locus of control). Patients rated their overall prescription medication adherence and estimated the number of days in the preceding month on which doses were missed. In addition, treating physicians estimated the degree to which the ED visit was related to medication non-adherence; clinical data were abstracted to help validate patient and physician assessments. The relationships between non-adherence and demographic, socioeconomic, and psychological variables were explored using multivariate statistics and logistic regression. Covariance analysis was performed to validate subscales, and receiver-operator curves were used to define optimal threshold values.

RESULTS: A total of 472 patients consented to participate, with good representation for various demographic and socioeconomic groups. Each psychological factor related significantly to both patient and physician ratings of non-adherence (p < 0.05). Of all demographic and socioeconomic factors examined, only current or historical drug use predicted non-adherence.

CONCLUSIONS: Psychological factors seem to be important determinants of medication non-adherence among ED patients. These data may help define future research directions and interventions.

Author List

Davis DP, Jandrisevits MD, Iles S, Weber TR, Gallo LC

Author

Matthew Jandrisevits PhD Assistant Professor in the Psychiatry and Behavioral Medicine department at Medical College of Wisconsin

MESH terms used to index this publication - Major topics in bold

Adult
Attitude to Health
Cross-Sectional Studies
Diabetes Mellitus
Emergency Service, Hospital
Female
Humans
Hypertension
Internal-External Control
Male
Medication Adherence
Middle Aged
Reproducibility of Results
Risk Factors
Seizures
Socioeconomic Factors