Medication Non-Adherence: An Invisible Epidemic An Exploration of Factors Contributing to the Psychology of Scarcity in an Urban Population of Disadvantaged Type 2 Diabetics

Abstract

This thesis is an exploration of the stressors taxing mental bandwidth among disadvantaged patients with type 2 diabetes at an urban health center in central New Jersey. Though rates of medication non-adherence in the present study were significantly lower than found in studies with similar populations (Kuo et al., 2003; Parada, Horton, Cherrington, Ibarra, & Ayala, 2012; Sclar et al., 1999), lack of social support was found to be positively associated with greater medication non-adherence. This relationship suggests a need for sustained tangible support interventions that allow patients to “offload,” onto others, some of the chores taxing their mental bandwidths. Objective treatment complexity has been positively associated with medication nonadherence in the literature, as it has with increased cognitive load (Boff, Kaufman & Thomas, 1994; Salthouse, 1992). Our results suggest perceived treatment complexity may also affect medication non-adherence and might benefit from further study. Positive associations between comparatively rated health status, mood, and concern about medications with perceived treatment complexity suggest the potential need to address these variables specifically in adherence improvement efforts. Lastly, we emphasize the need for low bandwidth strategies, namely reminders, to overcome scarcity and improve medication adherence.