TY - JOUR
T1 - Medication adherence in a nurse practitioner managed clinic for indigent patients
AU - Alton, Suzanne
AU - March, Alice L.
AU - Mallary, Laura
AU - Fiandt, Kathryn
PY - 2015/8/1
Y1 - 2015/8/1
N2 - Purpose: Little is published in the literature about medication adherence rates among patients who are medically indigent and patients receiving primary care from nurse practitioners (NPs). This project examined adherence rates and barriers to adherence among patients at an NP-managed health clinic (NPMC). Data sources: The setting for this research was an NPMC for uninsured and low-income patients. A cross-sectional convenience sample of patients (n = 119) completed surveys eliciting demographic information, self-report of medication adherence, health literacy, and barriers to adherence. Conclusions: Analysis of subjects demonstrated a vulnerable population, yet the mean adherence rate was surprisingly high (77%), compared to the rate usually cited in published literature. The best predictive model differentiating patients with high adherence from those with low adherence combined the total number of reported barriers, health literacy, and employment status. The barriers most frequently cited by subjects were difficulty paying for medications, and difficulty reading and understanding written prescription labels, which was particularly prevalent among Spanish-speaking patients. Implications for practice: Clinic efforts to improve patient access to affordable medications may have contributed to subjects' high rates of adherence. These efforts included helping patients with filling out prescription assistance program paperwork, prescribing generic medications, providing samples, and providing effective patient education.
AB - Purpose: Little is published in the literature about medication adherence rates among patients who are medically indigent and patients receiving primary care from nurse practitioners (NPs). This project examined adherence rates and barriers to adherence among patients at an NP-managed health clinic (NPMC). Data sources: The setting for this research was an NPMC for uninsured and low-income patients. A cross-sectional convenience sample of patients (n = 119) completed surveys eliciting demographic information, self-report of medication adherence, health literacy, and barriers to adherence. Conclusions: Analysis of subjects demonstrated a vulnerable population, yet the mean adherence rate was surprisingly high (77%), compared to the rate usually cited in published literature. The best predictive model differentiating patients with high adherence from those with low adherence combined the total number of reported barriers, health literacy, and employment status. The barriers most frequently cited by subjects were difficulty paying for medications, and difficulty reading and understanding written prescription labels, which was particularly prevalent among Spanish-speaking patients. Implications for practice: Clinic efforts to improve patient access to affordable medications may have contributed to subjects' high rates of adherence. These efforts included helping patients with filling out prescription assistance program paperwork, prescribing generic medications, providing samples, and providing effective patient education.
KW - Adherence
KW - Indigent
KW - Medications
KW - Nurse practitioners
KW - Nurse-managed clinics
KW - Practice models
KW - Vulnerable
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U2 - 10.1002/2327-6924.12211
DO - 10.1002/2327-6924.12211
M3 - Article
C2 - 25682757
AN - SCOPUS:84938288815
SN - 2327-6886
VL - 27
SP - 433
EP - 440
JO - Journal of the American Association of Nurse Practitioners
JF - Journal of the American Association of Nurse Practitioners
IS - 8
ER -