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PharmEcon > Medication Adherence and Assessment > Flashcards

Medication Adherence and Assessment Flashcards

1
Q

Adherence

A

The extent to which a person’s behavior corresponds with agreed upon recommendations from a health care provider

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2
Q

Medication adherence

A

The patient’s conformance with the provider’s recommendation with respect to timing, dosage, and frequency of medication-taking during the prescribed length of time

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3
Q

Persistence

A

Duration of time patient takes medication, from initiation to discontinuation of therapy

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4
Q

Primary Nonadherence

A

Primary nonadherence occurs when NEW prescriptions are never filled or picked up at the pharmacy

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5
Q

What are some reasons primary medication nonadherence are studied less than nonadherence associated with filled prescriptions?

A
  • Use of pharmacy claims data for adherence research
  • Cumbersome nature of reviewing office records for prescribed drugs and comparing to pharmacy records or claims data or reviewing data at the pharmacy level
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6
Q

What are some predictors for primary nonadherence?

A
  • Low income
  • Minority race
  • Patient prescribed a greater number of medications
  • Prescriptions written by primary care providers
  • Pain medications are the least likely drugs to be filled
  • Treatment of chronic conditions such as diabetes, hyperlipidemia, hypertension, especially for newly prescribed medication
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7
Q

Intentional nonadherence

A

Nonadherence based on an active, reasoned decision-making process

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8
Q

Unintentional nonadherence

A

Nonadherence that results from a more passive process

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9
Q

What are the 5 sets of factors that influence medication adherence?

A
  • Social/economic factors
  • Therapy-related factors
  • Patient-related factors
  • Condition-related factors
  • Health system/healthcare team factors
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10
Q

Proportion of Days Covered (PDC)

A

(Sum of days covered by prescription fills)/(Sum of days between first fill and end date of evaluation period )
* 80% is used to identify patient with good adherence
* Pharmacy Quality Alliance (PQA) endorses this over MPR
* Way to measure adherence

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11
Q

What are some advantages of medication adherence tools/questionnaires?

A
  • Measure true medication taking behaviors
  • Ascertain reasons behind nonadherence
  • Low cost
  • Easy to administer
  • Flexibility in timing of administration
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12
Q

What are some disadvantages of medication adherence tools/questionnaires?

A
  • Subject to patient recall and truthfulness
  • Take time to administer
  • No tool measures all potential nonadherence factors
  • Validity of tools
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13
Q

Morisky Medication Adherence Scale

A
  • 4 item scale
  • Can be easily administered to patients
  • Validated in low-literacy patients
  • Con: Economic factors not assessed
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14
Q

Medication Adherence Report Scale (MARS-5)

A
  • Measures unintentional and intentional nonadherence
  • 5-point Likert scale
  • Can be self-administered by patient
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15
Q

Self-Efficacy

A

The belief or confidence that a person can successfully perform a specific action to achieve a desired outcome

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16
Q

SEAMS (Self Efficacy for Appropriate Medication Use Scale)

A
  • Applies the concept of self-efficacy to medication management
  • Validated in several chronic diseases and in low literacy patients
  • 13 item scale
  • 3-point Likert scale
17
Q

What are some issues with SEAMS?

A
  • 13 items may be cumbersome to administer in a busy practice
  • Not clear how to use this scale/results in practice
  • Doesn’t address economic factors for nonadherence
18
Q

MUSE (Medication Understanding and Use Self-Efficacy Scale)

A
  • Measures self-efficacy of understanding and using prescription medications
  • Measures an individual’s perceived ability to seek out and understand their medications and to adhere to prescribed regimens
  • Can be used in low-literacy patients
  • 8 items with 4 point Likert response scale
  • Could be utilized to evaluate the impact of pharmacist adherence and education interventions (e.g., CMR; MTM)
  • Doesn’t address economic or therapy-related factors for nonadherence
19
Q

What is the population for BMQ (Brief Medication Questionnaire)

A
  • Diabetes, Depression, Hypertension (ACE inhibitors)

Complicated to administer and score

20
Q

What is the population for Hill-Bone Compliance Scale?

A

Hypertension

21
Q

What is the population for Adherence to Asthma Medication Questionnaire (AAMQ)?

A

Asthma

22
Q

Adherence to Asthma Medication Questionnaire (AAMQ)

A
  • 13 items with Likert Scale response
  • Wording specific to asthma including use of inhalers
  • Total scores correlate with excellent, moderate, and poor adherence

PharmEcon (1 decks)

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