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Factors Influencing Medication Adherence in High Risk Pregnant Patients [6E]

Mastrogiannis, Dimitrios, MD, PhD, MBA; Della Torre, Micaela, MD, MS; DiGiovanni, Laura, MD; Wedoff, Michael

doi: 10.1097/01.AOG.0000514798.32937.fe
Sunday, May 7, 2017

INTRODUCTION: Pregnant patients’ non-adherence with prescription medications is a challenging problem. The purpose of this study was to investigate factors influencing medication adherence in our urban high risk obstetric clinic.

METHODS: This is a prospective cross-sectional study performed February through June 2016 at the Maternal Fetal Medicine clinic at UIC. Participants were ≥24 weeks, English-speaking adults, and taking ≥1 prescription medication. After obtaining consent, study participants were surveyed by questionnaire. Answers were entered into 3 adherence scoring scales: Morisky 8 medication adherence score (MMAS-8), medication adherence reasons scale (MARS), and rapid estimate of adult literacy.

RESULTS: A total of 69 patients completed the questionnaire; 60% had unplanned pregnancies, and 45% had health literacy < 8th grade level. Adherence scores were low in 42%, moderate in 38%, and high in 20% of participants. Pregnant women with low adherence score were significantly more likely to be on higher number of medications (p=0.044) and had trended towards missed prenatal visits (p=0.056). 31.9% had asthma, 52.2% had diabetes, 44.9% had hypertension, 11.6% had thyroid disorders, and 4.3% had seizure disorders. Patients with hypertension had higher non-adherence compared to all other categories (p=0.037), and more commonly used marijuana (p < 0.001). Being employed, having a smartphone, dependents, and partner did not affect adherence scores. Women reporting forgetfulness, carelessness, medication side-effects, stopping medication when symptom free, travel, inconvenience, and difficulty calculating dose had low adherence scores.

CONCLUSION: Understanding the reasons for medication non-adherence in an urban high risk obstetric population may allow providers to tailor motivational interviewing to improve individual adherence.

University of Illinois at Chicago School of Medicine, Chicago, IL

Financial Disclosure: The authors did not report any potential conflicts of interest.

© 2017 by The American College of Obstetricians and Gynecologists. Published by Wolters Kluwer Health, Inc. All rights reserved.