ADHERING TO NEWLY PRESCRIBED MEDICATION IN THE ELDERLY: AN EXPERIMENTAL APPROACH

Purpose:

   This work aimed at gauging the impact of distinct factors known to differently impinge over elders’ decision to adhere to newly prescribed medication.

Method:

   The authors employed an experimental task combining 4 factors: severity of clinical condition (SCC), cost of medication (CM), regimen complexity (RC), and trust in the clinician (TC) (operationalized as clinician experience). The task was performed by a sample of 72 elder volunteering participants in a non-clinical context. Presented in a virtual environment (PC monitor), it embodied a sequence of scenarios each conveying the same cover story depicting an ordinary medical consultation, wherein a fictitious elder patient was about to decide whether to adhere to a new drug prescription the doctor was suggesting tackling his/hers present heart condition. Combining 3 levels of SCC (normal, serious, life threatening) and CM (75, 150, 225€, matching a 15% proportion of 500, 1000, and 1500€ monthly income respectively) with 2 levels of RC (complex and simple), and TC (experienced and highly experienced), the whole set of 18 randomized scenarios asked participants to respond in a Visual Analogical Scale ranging from “not at all adhering” to “totally adhering” how much they think the fictitious patient was willing to adhere to the new drug prescription.

Result:

   Results confirm previous findings: SCC and CM are chief factors to shape a response pattern of adherence to newly prescribed medication. Moreover, these two factors add up until “serious” level of SCC is hit, resulting in a ceiling effect of SCC precluding further impact of CM even at its highest level (225€ more accruing to patient current expenses). Our main concern here though is with some other found interactions, despite their observed lack of statistical significance, except for one. Participants previously clinically diagnosed with heart condition were more likely to perceive more willingness to adhere when confronted with trials combining prescribed complex regimen with highly experienced clinician than with simply experienced clinician. This latter factor of TC showed to have no significance as a main effect and no other significant effect of interaction with the remaining factors. 

Conclusion:

   We discuss this result as an interesting avenue of research with theoretical and practical potential for the design of communication protocols purported to enhance patient adherence to newly prescribed medication among the elderly.