Transcript Slide 40 - York College of Pennsylvania

The Effect of Drug Class and Safety Perception on the Medication
Adherence of Rheumatology Patients
Kathryn C. Fischer, Department of Biological Sciences York College of Pennsylvania
Methods
•Studies have determined specific factors
that effect adherence such as the dosing
regimen, side effects, cost, and pill
burden. Greater case management that
increases patient knowledge and the
understanding of patient concerns has
been effective in increasing medication
adherence (Vlasnik et al. 2005).
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Safety Perception
Figure 3. Analysis of patient safety perception for all patients
surveyed. Chi-Square statistical analysis provied the p value of
less than 0.0001 which supports rejection of the null hypothesis.
This supports a significant difference in perception of safety within
the patient population.
Data was compiled and statistical analysis
was performed using SPSS
Percentage of Discontinuation
Within Saftey Perception Categories
Percentage of Patients
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•Although medications for rheumatic
conditions are often directly related to
greater mobility and pain relief, patients
often discontinue long term therapy
(Harrold, 2008)
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Percentage of Patients
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Drug Class
Figure 2. Percentage of medication discontinuation for all
patients surveyed. Chi-Square statistical analysis provided a p
value of 0.120 which fails to reject the null hypothesis. This shows
no significant relationship between drug class and
discontinuation.
•It is now known that a significant amount of
patients who discontinue prescribed
medications at AACR feel the risks of side
effects outweigh the benefits of continuing
therapy. Factors influencing adherence such
as safety perception and motivation to
discontinue can be addressed in order to
intervene in patients who have concerns
about their long term therapy.
•Further research involving a greater
quantity of patients would increase the
significance of discontinuation, both within
specific drug classes and due to patient
safety perception.
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LITERATURE CITED
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Harrold, Leslie R., and Susan E. Andrade. "Medication Adherence of Patients with Selected Rheumatic
Conditions: A Systematic Review of Literature." Seminars in Arthritis and Rheumatism (2008).
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Klippel, John H., and Patience H. White, eds. Primer on the Rheumatic Diseases. New York: Springer, 2007.
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•Similar to past medication adherence
studies, the greatest motivation for
discontinuing long term medical therapy for
patients at AACR is side effects (Vlasnik et al.
2005).
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•Determine if there is a specific
motivation to discontinue medication
Patient Motivation for
Medication Discontinuation
Percentage of Discontinuation
Within Drug Classes
La
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•Determine If safety perception for
prescribed drug class effects medication
adherence
Figure 4. Percentage of patients who discontinued medication
within each saftey perception category. Chi-square statistical
analysis provided a p value of 0.164 which fails to reject the null
hypothesis. This shows no significant difference in saftey
perception and discontinuation of drug prescribed.
Results
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•Determine the medication adherence of
8 specific drug classes
Figure 1. Copy of survey distributed to patients at
Advanced Arthritis Care and Research in Scottsdale,
Arizona.
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Objective
Safety Perception
Percentage of Patients
•For patients with rheumatic conditions,
the effect of drug class and safety
perception on medication adherence is
not known. Such knowledge could
increase the rate of adherence and
minimize the loss of billions of dollars
while improving the quality of life of
patients with chronic rheumatic diseases.
•Patients who felt their prescribed
medication was dangerous discontinued
therapy 100% of the time. However, 75% of
patients felt their medication was safe or
moderately safe.
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•It is estimated that ½ of all patients skip
or discontinue long term medical therapy
for chronic illnesses and 1 out of 5
patients do not pick up filled
prescriptions (Reginster, 2006).
Surveys were distributed to 110 patients at
Advanced Arthritis Care and Research
in Scottsdale, Arizona over 21 days prior to
examination before the physician entered the room.
Completed surveys were delivered directly to the receptionist
after appointment. New patients were excluded from the study
and 10 patients declined to participate.
Conclusion
•Immunosuppressant drugs were
discontinued the most. Pain Relievers and
Corticosteroids were discontinued the least.
However, only 27 of 100 patients described
discontinuing their medication.
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•Medication discontinuation and
subsequent failure of treatment results in
10% of hospitalizations (Harrold, 2008).
A survey was developed regarding
patient disorder and medication,
safety perception, media observations,
personal conversations, medication discontinuation,
and motivation to discontinue.
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•Poor adherence to medication results in
$300 billion of unnecessary health care
(Vlasnik et al. 2005)
Percentage of Patients
Introduction
Patient Saftey Perception
for Drug Class Perscribed
Motivation
Figure 5. Analysis of patient motivation and medication
discontinuation. A non-parametric Chi-Square test resulted in a
p value of 0.004 which rejects the null hypothesis. This supports
a significant difference in motivation of skipping or discontinuing
medication.
Reginster, Jean-Yves. "Adherence and persistence: Impact on outcomes and health care resources." Bone
38 (2006): 18-21.
Vlasnik, Jon J., Sherry L. Aliotta, and Bonnie DeLor. "Medication Adherence Factors Influencing
Compliance with Prescribed Medication Plans." The Case Manager 16 (2005): 47-51.
Whitley, Heather P., Joli D. Fermo, Kelly Ragucci, and Eleanor C. Chumney. "Assessment of patient
knowledge of diabetic goals, self-reported medication adherence, and goal attainment." Pharmacy
Practice 4 (2006): 183-90.
ACKNOWLEDGEMENT
•I would like to thank Dr. Warren C. Rizzo of Advanced Arthritis Care and Research
in Scottsdale, Arizona for my internship experience and guidance.
•Also thanks to mentors Dr. Carolyn Mathur and Dr. Joshua Landau for their
guidance.
•And a special thanks to Peter and Alison Fischer for their ever present inspiration
to better the lives of individuals with rheumatic diseases.