Moderating Effects of Occupational Health Exposures and Medication Adherence: Models for Improved Adherence

BACKGROUND:

Medication non-adherence is a major problem in the management of chronic diseases, especially diabetes and cardiovascular disease.  It is expected that chronic disease will affect nearly half of the U.S. population by 2025.  Hospitalizations related to medication non-adherence contribute to approximately 100 billion a year in healthcare costs.  The effect that medication non-adherence will have on this country’s population and economy is great.  Examining factors that strengthen our understanding of adherence is essential. 

METHODS:

Medical adherence, health care utilization, psychosocial assessment, and chronic disease status data from 216 participants enrolled in the randomized clinical trial, “Effect of Community Pharmacist Intervention on adherence to Long-term Medications” or Eco-PHIL study, were examined as to whether occupational health history moderates medication adherence.  Multivariate analysis was used to determine if an affect exists on patients enrolled in the standard care treatment group (111) and patients enrolled in the intervention (pill box + motivational interviewing) treatment group (105).

 

PUBLIC HEALTH SIGNIFICANCE:

By examining the effects of occupational history on medication adherence in a population of patients with diabetes and cardiovascular disease, a theoretical link between occupational history and medication adherence might be associated with the patient’s educational level and income and it may also be associated with his/her psychosocial status. 

CONCLUSIONS: 

Models depicting the association between patient factors could help employers understand how to better target patients who are at increased risk for poor medication adherence thus leading to slower disease progression, reduced mortality and decreased healthcare costs.