Medication adherence and the factors that influence it among members enrolled in the City Health Works! Program

Background: Suboptimal adherence to medications is an age old problem of great public health significance. While its prevalence (~50%) and the factors that influence it are fairly well known for the general population, they have not been fully explored for the population that enrolls in the City Health Works! (CHW!) program.;Methods: This study consisted of a retrospective review of the charts of all members enrolled in the CHW! program by April 30th, 2014. It sought to identify and quantify the most common causes of suboptimal medication adherence in this particular population through a review of the data available in intake forms, a medication assessment worksheet, and a health coach administered self-assessment questionnaire based on GlaxoSmithKline's ASK-20 survey.;Results: Suboptimal medication adherence was a significant problem in this population, with 75% of members reporting at least one medication adherence issue in the past month and 27.5% reporting having taken more or less of a medication than prescribed in the past month. The most common medication adherence issue identified was forgetting. Other factors related to forgetting were also identified as issues contributing to suboptimal medication adherence. Several medication regimen related issues such as unpleasant side effects to medication were also commonly reported.;Conclusions: Forgetting was a common barrier to medication adherence in this study, but may also reflect deeper issues that lead to suboptimal adherence, such as a low perceived value in taking a medication as well as a low motivation for taking it. Unpleasant side effects to medications were also a prominent issue. CHW! staff can enhance members' medication adherence behavior through counseling, support, and education. Approaches that enhance a person's perceived value in taking a medication may prove helpful for those in whom forgetting is an issue, while working closely with prescribers to develop a medication regimen that a member can easily adhere to may help with medication regimen related adherence issues.