Abstract
Background: Cost-related medication non-adherence may be influenced by patients’ perceived importance of their medications.
Objectives: This exploratory pilot study addresses three related but distinct questions: Do patients perceive different levels of importance among their medications? What factors influence perceptions of medication importance? Is perceived importance associated with perceived worth of medications, and does expense impact on that association?
Methods: Study participants included individuals aged ≥60 years who were taking three or more prescription drugs. Semi-structured, in-person interviews were conducted to measure how patients rated their medications in terms of importance, expense and worth. Factors that influenced medication importance were identified using qualitative analysis. Ordinal logistic regression analyses were employed to examine the association between perceived importance and perceived worth of medications, and the impact of expense on that association.
Results: For 143 prescription drugs reported by 20 participants, the weighted mean rating of medication importance was 8.2 (SD 1.04) on a scale from 0 (not important at all) to 10 (most important). Patients considered 38% of these medications to be expensive. The weighted mean rating of worth was 8.4 (SD 1.46) on a scale from 0 (not worth it at all) to 10 (most worth). Three major factors influenced medication importance: drug-related (characteristics, indications, effects and alternatives); patient-related (knowledge, attitudes and health); and external (the media, healthcare and family caregivers, and peers). Regression analyses showed an association between perceived importance and perceived worth for inexpensive medications (odds ratio [OR] 2.23; p = 0.002) and an even greater association between perceived importance and perceived worth for expensive medications (OR 4.29; p < 0.001).
Discussion: This study provides preliminary evidence that elderly patients perceive different levels of importance for their medications based on factors beyond clinical efficacy. Their perception of importance influences how they perceive their medications’ worth, especially for medications of high costs. Understanding how patients perceive medication importance may help in the development of interventions to reduce cost-related non-adherence.
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Acknowledgements
No sources of funding were used to assist in the preparation of this study. During part of this study, Dr Lau was supported by a K-01 career development award from the National Institutes of Health (grant no.: 5K01AG027295-02). The authors have no conflicts of interest that are directly relevant to the content of this study.
The authors are very grateful to Mr Scott Anderson, Ms Theresa Kowalski, Ms Shalini Singh, Mr Andrew T. Harris and Dr Adnan Arseven for their assistance throughout this project. The authors also sincerely thank Dr Kelly Michelson for her comments on an earlier version of this article.
An earlier version of this paper was presented at the Gerontological Society of America 60th Annual Scientific Meeting in San Francisco, CA, USA on 18 November 2007.
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Lau, D.T., Briesacher, B.A., Mercaldo, N.D. et al. Older Patients’ Perceptions of Medication Importance and Worth. Drugs Aging 25, 1061–1075 (2008). https://doi.org/10.2165/0002512-200825120-00007
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DOI: https://doi.org/10.2165/0002512-200825120-00007