A conceptually based approach to understanding chronically ill patients' responses to medication cost pressures.

A conceptually based approach to understanding chronically ill patients' responses to medication cost pressures. Research Abstract Details 

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A conceptually based approach to understanding chronically ill patients' responses to medication cost pressures. Abstract Text:

John D Piette,Michele Heisler,Robert Horne,G Caleb Alexander,John D Piette,Michele Heisler,Robert Horne,G Caleb Alexander,

Prescription medications enhance the well-being of most chronically ill patients. Many individuals, however, struggle with how to pay for their treatments and as a result experience problems with self-care and health maintenance. Although studies have documented that high out-of-pocket costs are associated with medication non-adherence, little research on prescription cost sharing has been theoretically grounded in knowledge of the more general determinants of patients' self-management behaviors and chronic disease outcomes. We present a conceptual framework for understanding the influence of patient, medication, clinician, and health system factors on individuals' responses to medication costs. We review what is known about how these factors influence medication adherence, identify possible strategies through which clinicians, health systems, and policy-makers may assist patients burdened by their medication costs, and highlight areas in need of further research. Although medication costs represent a burden to chronically ill patients worldwide, most patients report using their medication as prescribed despite the costs, and others report cost-related underuse despite an apparent ability to afford those treatments. The cost-adherence relationship is modified by contextual factors, including patients' characteristics (e.g., age, ethnicity, and attitudes toward medications), the type of medications they are using (e.g., the complexity of dosing and the drug's clinical target), clinician factors (e.g., choice of first-line agent and communication about medication costs), and health system factors (e.g., efforts to influence clinicians' prescribing and to help patients apply for financial assistance programs). Understanding these relationships will enable clinicians and policy-makers to better design pharmacy benefits and assist patients in taking their medication as prescribed. The next generation of studies examining the consequences of prescription drug costs should expand our knowledge of the ways in which these co-factors influence patients' responses to medication cost pressures.

A conceptually based approach to understanding chronically ill patients' responses to medication cost pressures. Publishing Authors By Initials

JD Piette,M Heisler,R Horne,G Caleb Alexander,JD Piette,M Heisler,R Horne,G Caleb Alexander,

For similar behavior and behavior mechanisms: behavior: health behavior: treatment refusal research abstracts see: behavior and behavior mechanisms: behavior: health behavior: treatment refusal research

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A conceptually based approach to understanding chronically ill patients' responses to medication cost pressures. Journal Published:

PUBLICATION TYPE: Review

Journal: Social science & medicine (1982)

VOLUME: 62

Page Numbers: 846-57

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ISSN: 0277-9536

DAY: 10

MONTH: 08

YEAR: 2005

A conceptually based approach to understanding chronically ill patients' responses to medication cost pressures. Information

Number of References: 126

LANGUAGE: eng

NlmUniqueID: 8303205

A conceptually based approach to understanding chronically ill patients' responses to medication cost pressures. Keywords Mesh Terms:

KEYWORDS: Treatment Refusal

MESH TERMS: psychology

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Grant and Affiliation Information for A conceptually based approach to understanding chronically ill patients' responses to medication cost pressures.

AFFILIATION: VA Healthcare System and University of Michigan, Ann Arbor, MI, USA. jpiette@umich.edu

Country: England

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MEDLINETA: Soc Sci Med

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