Patient Pill Organization Strategies and Adherence Measured in a Cross-Sectional Study of Hypertension
Matthew P Genelin,1 Laura J Helmkamp,2 John F Steiner,1,3 Julie A Maertens,2 Rebecca Hanratty,1,4 Suma Vupputuri,5 Edward P Havranek,1,4,6 L Miriam Dickinson,1,2 Irene V Blair,7 Stacie L Daugherty1– 3,6 1University of Colorado School of Medicine, Aurora, CO, USA; 2Adult and Child Consortium for Outc...
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| Format: | Article |
| Language: | English |
| Published: |
Dove Medical Press
2023-03-01
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| Series: | Patient Preference and Adherence |
| Subjects: | |
| Online Access: | https://www.dovepress.com/patient-pill-organization-strategies-and-adherence-measured-in-a-cross-peer-reviewed-fulltext-article-PPA |
| _version_ | 1797861348566106112 |
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| author | Genelin MP Helmkamp LJ Steiner JF Maertens JA Hanratty R Vupputuri S Havranek EP Dickinson LM Blair IV Daugherty SL |
| author_facet | Genelin MP Helmkamp LJ Steiner JF Maertens JA Hanratty R Vupputuri S Havranek EP Dickinson LM Blair IV Daugherty SL |
| author_sort | Genelin MP |
| collection | DOAJ |
| description | Matthew P Genelin,1 Laura J Helmkamp,2 John F Steiner,1,3 Julie A Maertens,2 Rebecca Hanratty,1,4 Suma Vupputuri,5 Edward P Havranek,1,4,6 L Miriam Dickinson,1,2 Irene V Blair,7 Stacie L Daugherty1– 3,6 1University of Colorado School of Medicine, Aurora, CO, USA; 2Adult and Child Consortium for Outcomes Research and Delivery Sciences (ACCORDS), University of Colorado, Aurora, CO, USA; 3Institute for Health Research, Kaiser Permanente Colorado, Denver, CO, USA; 4Department of Medicine, Denver Health and Hospital Authority, Denver, CO, USA; 5Mid-Atlantic Permanente Research Institute, Kaiser Permanente Mid-Atlantic States, Rockville, MD, USA; 6Department of Medicine, Division of Cardiology, University of Colorado School of Medicine, Aurora, CO, USA; 7Department of Psychology and Neuroscience, University of Colorado Boulder, Boulder, CO, USACorrespondence: Matthew P Genelin, University of Colorado School of Medicine, 3500 Rockmont Drive, #15-209, Denver, CO, 80202, USA, Email matthew.genelin@cuanschutz.eduBackground: The strategies patients use to organize medications (eg, pill dispenser) may be reflected in adherence measured at follow-up. We studied whether medication organization strategies patients use at home are associated with adherence measured using pharmacy-fills, self-report, and pill counts.Design: Secondary analysis of data from a prospective randomized clinical trial.Setting: Eleven US safety-net and community primary care clinics.Patients: Of the 960 enrolled self-identified non-Hispanic Black and White patients prescribed antihypertensive medications, 731 patients reported pill organization strategies and were included.Variable: Patients were asked if they use any of the following medication organization strategies: finish previous refills first; use a pill dispenser; combine same prescriptions; or combine dissimilar prescriptions.Outcomes: Adherence to antihypertensive medications using pill counts (range, 0.0– 1.0% of the days covered), pharmacy-fill (proportion of days covered > 90%), and self-report (adherent/non-adherent).Results: Of the 731 participants, 38.3% were men, 51.7% were age ≥ 65, 52.9% self-identified as Black or African American. Of the strategies studied, 51.7% finished previous refills first, 46.5% used a pill dispenser, 38.2% combined same prescriptions and 6.0% combined dissimilar prescriptions. Median (IQR) pill count adherence was 0.65 (0.40– 0.87), pharmacy-fill adherence was 75.7%, and self-reported adherence was 63.2%. Those who combined same prescriptions had significantly lower measured pill count adherence than those who did not (0.56 (0.26– 0.82) vs 0.70 (0.46– 0.90), p< 0.01) with no significant difference in pharmacy-fill (78.1% vs 74%, p=0.22) or self-reported adherence (63.0% vs 63.3%, p=0.93).Conclusion: Self-reported medication organization strategies were common. Combining same prescriptions was associated with lower adherence as measured using pill counts but not pharmacy-fills or self-report. Clinicians and researchers should identify the pill organization strategies used by their patients to understand how these strategies may influence measures of patient adherence.Trial Registration: ClinicalTrials.gov NCT03028597; https://clinicaltrials.gov/ct2/show/NCT03028597 (Archived by WebCite at http://www.webcitation.org/72vcZMzAB).Keywords: hypertension, medication adherence, management strategies, organization strategies, medication management behaviors, chronic disease, pill count, pharmacy-fill, self-reported adherence |
| first_indexed | 2024-04-09T22:00:46Z |
| format | Article |
| id | doaj.art-553beffbd99e45f2a2a41d02be2ce099 |
| institution | Directory Open Access Journal |
| issn | 1177-889X |
| language | English |
| last_indexed | 2024-04-09T22:00:46Z |
| publishDate | 2023-03-01 |
| publisher | Dove Medical Press |
| record_format | Article |
| series | Patient Preference and Adherence |
| spelling | doaj.art-553beffbd99e45f2a2a41d02be2ce0992023-03-23T18:06:53ZengDove Medical PressPatient Preference and Adherence1177-889X2023-03-01Volume 1781782682499Patient Pill Organization Strategies and Adherence Measured in a Cross-Sectional Study of HypertensionGenelin MPHelmkamp LJSteiner JFMaertens JAHanratty RVupputuri SHavranek EPDickinson LMBlair IVDaugherty SLMatthew P Genelin,1 Laura J Helmkamp,2 John F Steiner,1,3 Julie A Maertens,2 Rebecca Hanratty,1,4 Suma Vupputuri,5 Edward P Havranek,1,4,6 L Miriam Dickinson,1,2 Irene V Blair,7 Stacie L Daugherty1– 3,6 1University of Colorado School of Medicine, Aurora, CO, USA; 2Adult and Child Consortium for Outcomes Research and Delivery Sciences (ACCORDS), University of Colorado, Aurora, CO, USA; 3Institute for Health Research, Kaiser Permanente Colorado, Denver, CO, USA; 4Department of Medicine, Denver Health and Hospital Authority, Denver, CO, USA; 5Mid-Atlantic Permanente Research Institute, Kaiser Permanente Mid-Atlantic States, Rockville, MD, USA; 6Department of Medicine, Division of Cardiology, University of Colorado School of Medicine, Aurora, CO, USA; 7Department of Psychology and Neuroscience, University of Colorado Boulder, Boulder, CO, USACorrespondence: Matthew P Genelin, University of Colorado School of Medicine, 3500 Rockmont Drive, #15-209, Denver, CO, 80202, USA, Email matthew.genelin@cuanschutz.eduBackground: The strategies patients use to organize medications (eg, pill dispenser) may be reflected in adherence measured at follow-up. We studied whether medication organization strategies patients use at home are associated with adherence measured using pharmacy-fills, self-report, and pill counts.Design: Secondary analysis of data from a prospective randomized clinical trial.Setting: Eleven US safety-net and community primary care clinics.Patients: Of the 960 enrolled self-identified non-Hispanic Black and White patients prescribed antihypertensive medications, 731 patients reported pill organization strategies and were included.Variable: Patients were asked if they use any of the following medication organization strategies: finish previous refills first; use a pill dispenser; combine same prescriptions; or combine dissimilar prescriptions.Outcomes: Adherence to antihypertensive medications using pill counts (range, 0.0– 1.0% of the days covered), pharmacy-fill (proportion of days covered > 90%), and self-report (adherent/non-adherent).Results: Of the 731 participants, 38.3% were men, 51.7% were age ≥ 65, 52.9% self-identified as Black or African American. Of the strategies studied, 51.7% finished previous refills first, 46.5% used a pill dispenser, 38.2% combined same prescriptions and 6.0% combined dissimilar prescriptions. Median (IQR) pill count adherence was 0.65 (0.40– 0.87), pharmacy-fill adherence was 75.7%, and self-reported adherence was 63.2%. Those who combined same prescriptions had significantly lower measured pill count adherence than those who did not (0.56 (0.26– 0.82) vs 0.70 (0.46– 0.90), p< 0.01) with no significant difference in pharmacy-fill (78.1% vs 74%, p=0.22) or self-reported adherence (63.0% vs 63.3%, p=0.93).Conclusion: Self-reported medication organization strategies were common. Combining same prescriptions was associated with lower adherence as measured using pill counts but not pharmacy-fills or self-report. Clinicians and researchers should identify the pill organization strategies used by their patients to understand how these strategies may influence measures of patient adherence.Trial Registration: ClinicalTrials.gov NCT03028597; https://clinicaltrials.gov/ct2/show/NCT03028597 (Archived by WebCite at http://www.webcitation.org/72vcZMzAB).Keywords: hypertension, medication adherence, management strategies, organization strategies, medication management behaviors, chronic disease, pill count, pharmacy-fill, self-reported adherencehttps://www.dovepress.com/patient-pill-organization-strategies-and-adherence-measured-in-a-cross-peer-reviewed-fulltext-article-PPAhypertensionmedication adherencemanagement strategiesorganization strategiesmedication management behaviorschronic diseasepill countpharmacy-fillself-reported adherence |
| spellingShingle | Genelin MP Helmkamp LJ Steiner JF Maertens JA Hanratty R Vupputuri S Havranek EP Dickinson LM Blair IV Daugherty SL Patient Pill Organization Strategies and Adherence Measured in a Cross-Sectional Study of Hypertension Patient Preference and Adherence hypertension medication adherence management strategies organization strategies medication management behaviors chronic disease pill count pharmacy-fill self-reported adherence |
| title | Patient Pill Organization Strategies and Adherence Measured in a Cross-Sectional Study of Hypertension |
| title_full | Patient Pill Organization Strategies and Adherence Measured in a Cross-Sectional Study of Hypertension |
| title_fullStr | Patient Pill Organization Strategies and Adherence Measured in a Cross-Sectional Study of Hypertension |
| title_full_unstemmed | Patient Pill Organization Strategies and Adherence Measured in a Cross-Sectional Study of Hypertension |
| title_short | Patient Pill Organization Strategies and Adherence Measured in a Cross-Sectional Study of Hypertension |
| title_sort | patient pill organization strategies and adherence measured in a cross sectional study of hypertension |
| topic | hypertension medication adherence management strategies organization strategies medication management behaviors chronic disease pill count pharmacy-fill self-reported adherence |
| url | https://www.dovepress.com/patient-pill-organization-strategies-and-adherence-measured-in-a-cross-peer-reviewed-fulltext-article-PPA |
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