NIH Record - National Institutes of Health

Effective Medicine Adherence Discussed in NINR Lecture

Dunbar-Jacob and Grady hold plaque
Dr. Jacqueline Dunbar-Jacob (l) and Dr. Patricia Grady, NINR director

Dr. Jacqueline Dunbar-Jacob presented her work on patient medication adherence at 2015’s second NINR Director’s Lecture. Fellow scientists and health care professionals attended her talk, “Scientific Pursuit of Effective Medicine Adherence.” 

Dunbar-Jacob, distinguished service professor and dean of the School of Nursing at the University of Pittsburgh, was quick to point out that problems of adherence have existed since the time of Plato. However, with the rise of chronic conditions today—7 out of 10 deaths in the United States result from chronic disease—medication adherence has become a costly problem both monetarily and in regard to the quality of life for patients. 

Dunbar-Jacob cited previous research where, of 100 patients given a prescription, 70–72 percent will fill it, 56 percent will refill it and only 28 percent will take the prescription correctly. Clearly, patient medication adherence is a “problem of significant magnitude.” To address this problem, she proposed looking across studies to identify individual patterns that could lead to tailored interventions to improve adherence.

When exploring what poor adherence looks like, Dunbar-Jacob showed data from a group of patients who took about 70 percent of their medication doses. The data showed that behavior patterns varied greatly, even though the average adherence was the same. She also described the differences found when adherence was measured by self-report versus electronic event monitoring and other methods of measuring medication adherence. These differences led to the identification of various sociodemographic characteristics and baseline predictors of adherence even within the same population. 

Summarizing data from her recent work, Dunbar-Jacob reiterated that, due to differences in measurement methods and identification of who adheres, the factors predicting adherence and the patterns of adherence vary greatly. She also emphasized the need for more research in medication adherence and expressed the need to include more diverse populations in future studies. 

Dunbar-Jacob’s lecture is available on NINR’s YouTube channel at—Lindsey O’Keefe

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