Medication Nonadherence and its Relation to Financial Restriction

Journal of Transplant Coordination, Vol. 9, Number 3, September 1999 medication nonadherence is considered a psychosocial issue (ie, pathologic), requiring a clinical intervention rather than a financial one. Only recently, there has been a serious exploration of the relationship between financial factors and medication nonadherence.4-6 In 1994, using factors based on clinical observation, the Integris Oklahoma Transplantation Institute explored the relationship of medication nonadherence (immunosuppressive and other medications) among 100 consecutive heart transplant recipients seen in the outpatient clinic.7 Outpatient nurse coordinators, who were unaware of the purposes of the study, collected data from patient interviews and review of the medical chart. Nonadherence was defined as “had not taken the medications as prescribed on, at least, 1 (or more) occasions out of 10.” Twenty-five percent of the recipients were found to be nonadherent with regard to at least 1 or more of their overall medication therapy (excluding immunosuppressive medications), but only 3% of these recipients were nonadherent with regard to their immunosuppressive medications. Nonadherent recipients were more likely (P<.01) to have been dependent on state Medicaid and/or multiple indigent drug programs. It was concluded that if optimum transplant results were to be obtained, every effort must be made to provide recipients with the Medication nonadherence and its relation to financial restriction