Association of age, health literacy, and medication management strategies with cardiovascular medication adherence.

Abstract

OBJECTIVE: To examine patients' use of medication management strategies (e.g., reminders, pill boxes), and to determine how their use influences the relationship between patient characteristics and medication adherence. METHODS: Retrospective and cross-sectional study of 434 patients with coronary heart disease, examining both refill adherence and self-reported adherence. RESULTS: The most common strategy for managing refills was seeing a near empty pill bottle (89.9%), and for managing daily medications, it was associating medications with daily events (80.4%). Age<65 (OR = 1.7), as well as marginal (OR = 2.0) or inadequate health literacy (OR = 1.9), was independently associated with low refill adherence. Patients <65 also had lower self-reported adherence (OR = 1.8). Adjustment for use of medication management strategies did not substantially change these relationships. Reliance on reminders from friends or family to take medications, or waiting to refill a medicine only when the bottle was near empty, each were associated with 3-fold greater odds of non-adherence. CONCLUSION: Age <65 and marginal or inadequate health literacy were independently associated with medication non-adherence. Use of medication management strategies did not explain these relationships. PRACTICE IMPLICATIONS: The strategies which patients report using to assist with managing medication refills and daily medication use may be ineffective.