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Factors Affecting Medication Adherence Cheat Sheet (DRAFT) by [deleted]

Factors Affecting Medication Adherence

This is a draft cheat sheet. It is a work in progress and is not finished yet.

1. Social & Economic Dimension

Limited English language profic­iency
Low health literacy
Lack of family or social support network
Unstable living condit­ions; homele­ssness
Burdensome schedule
Limited access to health care facilities
Lack of health care insurance Inability or difficulty accessing pharmacy Medication cost
Cultural and lay beliefs about illness and treatment
Elder abuse

2. Healthcare System Dimension

Provid­er-­patient relati­onship
Provider commun­ication skills (contr­ibuting to lack of patient knowledge or unders­tanding of the treatment regimen)
Disparity between the health beliefs of the health care provider and those of the patient
Lack of positive reinfo­rcement from the health care provider
Weak capacity of the system to educate patients and provide follow-up
Lack of knowledge on adherence and of effective interv­entions for improving it Patient inform­ation materials written at too high literacy level
Restricted formul­aries; changing medica­tions covered on formul­aries
High drug costs, copaym­ents, or both
Poor access or missed appoin­tments
Long wait times
Lack of continuity of care

3. Condit­ion­-Re­lated Diemsnion

Chronic conditions
Lack of symptoms
Severity of symptoms
Psychotic disorders
Mental retard­ati­on/­dev­elo­pmental disability

4. Therap­hy-­Related Dimension

Complexity of medication regimen (number of daily doses; number of concurrent medica­tions)
Treatment requires mastery of certain techniques (injec­tions, inhalers)
Duration of therapy
Frequent changes in medication regimen
Lack of immediate benefit of therapy
Medica­tions with social stigma attached to use
Actual or perceived unpleasant side effects
Treatment interferes with lifestyle or requires signif­icant behavioral changes

Medication Non-Ad­herance Factors

5. Patien­t-R­elated Dimension

Physical Factors
Visual impairment
Hearing impairment
Cognitive impairment
Impaired mobility or dexterity
Swallowing problems

Psycho­log­ica­l/B­eha­vioral Factors
Knowledge about disease
Perceived risk/s­usc­ept­ibility to disease
Unders­tanding reason medication is needed
Expect­ations or attitudes toward treatment
Perceived benefit of treatment
Confidence in ability to follow treatment regimen
Fear of possible adverse effects
Fear of dependence
Feeling stigma­tized by the disease
Frustr­ation with health care providers
Psycho­social stress, anxiety, anger
Alcohol or substance abuse