WASHINGTON -- Emergency department patients are more likely to adhere to their prescribed medications when they believe the drugs are important, according to a study presented here, and they are more likely to perceive importance if they understand why the drugs have been prescribed.
Cameron Smyres, MD, and colleagues at the University of California San Diego surveyed 1,268 patients over 18 months, finding a significant association between patients' knowledge of medications and whether they perceived the drugs to be important. In addition, their stated degree of importance was "highly associated" with medication adherence, according to at the American College of Emergency medicine .
Compared with having little to no understanding of what a medication was prescribed for, patients were twice as likely to label a medication "very important" even when they had only a general grasp of its purpose.
And among those who ranked their medications "very important," 95% took them -- while only 55% of those who ranked their drugs as "not important" complied.
"If you can get people to understand the importance of medication, it correlates with them taking it," said Smyres.
ED personnel need to do better at educating patients about prescribed medications, Smyres said, whether that means engaging nurses more often or physicians finding the time. "Nothing beats a physician taking a moment," he said, suggesting they focus on discussing the most important medications they prescribe and asking patients why they adhere -- and don't adhere -- to their prescriptions.
But "it can be hard" for emergency physicians to squeeze in those conversations, Smyres acknowledged. "Everything is resources."
The researchers also compared how two groups of blinded providers perceived the medications' importance, and then contrasted the groups' beliefs with patient attitudes. While the majority of providers (62% and 62.8%, respectively) agreed with each other, the physician groups agreed with patients in only 34.1% and 37% of cases.
For the study, Smyres and colleagues used a convenience sample of patients from two academic EDs spanning April 2015 to October 2016.
The average patient had an income of under $20,000; 50.2% were male with a median age range of 55-59. About half were white, 16% were African American and 16% were Hispanic.
Patients were included if they were English-speaking, at least 18 year old, and taking at least two medications.
The researchers examined medication compliance and associations with patient attitudes, Smyres said, but they did not query why the individual patients took their specified drugs.
Smyres and colleagues concluded: "ED physicians and staff should make a concerted effort to educate patients on the utility and importance of their medications to improve adherence and reduce adherence related complications."
Primary Source
American College of Emergency Medicine
Coyne C, et al "The relationship between medication knowledge, perceived importance, and medication adherence" ACEP 2017; Abstract 433.