Patient activation and medication adherence in adults

Abstract

BackgroundPatients’ level of medication adherence provides conflicting results in its relationship to patient activation. Multiple factors may be contributing to these mixed results. ObjectivesThe primary purpose was to assess the association of patient activation to medication adherence in adults with chronic health conditions and low health literacy (HL). Secondary objectives were to determine whether age, education, gender, and race were associated with activation. MethodsParticipants completed self-report questionnaires regarding chronic disease self-management. Patient activation was measured using Hibbard’s Patient Activation Measure (PAM). Self-report of medication adherence was determined using the Gonzalez-Lu adherence questionnaire. Block regressions first assessed the relation of demographic variables and education to adherence and then the added relation of patient activation in a second model. ResultsThe analyses included 301 participants (mean age 58 years; 53% female; mean chronic conditions of 6.6). Some of the most common chronic conditions included hypertension (60%), arthritis (51%), depression (49%), and hyperlipidemia (43%). The relation of older age to greater medication adherence was significant (P < 0.05) in both models. The addition of PAM was significantly related to better adherence (P < 0.001) and also increased the R squared value from 0.04 to 0.09. This change resulted in a moderate effect size (d = 0.50). ConclusionEvaluating patient activation at baseline may predict those more likely to be medication adherent in patients with low HL.