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Publication Date

7-13-2010

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Advisors: Rickie Brawer, PhD, MPH--Thomas Jefferson University/Hospital; and Louis Weinstein-- TJU Department of Family & Community Medicine

Abstract

This study was conducted at an urban transitional housing facility, which also has a free primary care clinic staffed by physicians from the Department of Family & Community Medicine at TJU. The aim of the study was to investigate the factors that relate to medication adherence among patients living in an urban recovery residence and undergoing recovery from substance abuse. Research conducted on medication adherence in this patient population is sparse; furthermore, none of the available medication adherence tools have been studied in this population. Research methods in this study included a validated questionnaire, chart reviews, and in-depth interviews. The study was conducted in two phases: 1) The Adherence-Starts-with Knowledge (ASK), a 12-item questionnaire, was administered to 16 patients and a medication use audit was conducted; and 2) Eight patients were interviewed individually to discuss their medication taking habits and results of the ASK-12 questionnaire in detail. All patients had co-occurring psychiatric illnesses; eight of the 16 had chronic conditions such as cardiovascular, pulmonary, hepatic, and neurologic diseases. The scheduled medication adherence rates ranged from 0% to 97% in patients with chronic conditions. Of the eight patients who were interviewed, six received full benefits from the Veteran's Administration, while two patients were on state medical assistance; an impact on healthcare satisfaction was observed. Patients whose medication adherence rates were > 80% were more likely to be engaged in their own care, concerned about their health, and had more dialog with their health care professional. The limitations of this study were that medication administration records were not complete and missing data; conducting pill counts other than the current month was challenging due to retrospective data. Incorporating medication adherence questionnaires may be a helpful tool in this patient population, and will be investigated for its widespread use.

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