title: Alcohol use and adherence to prescribed therapy among under-served Latino and African-American patients using emergency department services.
abstract: Non-adherence to prescribed therapy is a factor that results in many patients attending emergency departments. However, increasingly, we recognize that patients who seek health care from inner-city emergency departments are among those experiencing health disparities. For these marginalized patients, emergency departments can play an important role in complementing the process of individualized care to achieve successful health outcomes. Research that examines socio-psychological characteristics and correlates of healthcare utilization of emergency department service users among under-served minority patients is needed for redirecting appropriate care among this segment of our population.
  
  
  OBJECTIVE
  This study examines the prevalence and correlates of adherence to prescribed therapy among patients presenting to an inner-city emergency department for a medical emergency or trauma injury. Specific attention is paid to the role of alcohol.
  
  
  METHODS
  A cross-sectional face-to-face survey was conducted among a consecutive sample of 412 Hispanic and African Americans aged 18 years and older who sought care at an inner-city emergency department facility.
  
  
  RESULTS
  Among patients who use medication (N=145), 32% reported low adherence. More than 24% scored positive for alcohol problems based on the Alcohol Use Disorders Identification Test (AUDIT). Results of multivariate regression analysis showed that those emergency department patients who: 1) identified themselves as Hispanic, 2) reported excessive use of alcohol, 3) reported a higher number of depressive symptoms, and 4) reported a higher number of alcohol related consequences were less likely to adhere to prescribed therapy.
  
  
  CONCLUSIONS
  Future investigation regarding factors related to adherence to prescribed medication among emergency department patients should take into consideration the role of alcohol and depression in this process. Further research is also needed to factor in patient's ethnicity in the context of treatment adherence.
authors.affiliation: Department of Psychiatry, Charles R. Drew University of Medicine & Science, Los Angeles, California 90059, USA.
authors.forename: Shahrzad
authors.initials: S
authors.lastname: Bazargan-Hejazi
authors.forename: Mohsen
authors.initials: M
authors.lastname: Bazargan
authors.forename: Eugene
authors.initials: E
authors.lastname: Hardin
authors.forename: Eric G
authors.initials: EG
authors.lastname: Bing
mesh_terms: D000328:Adult; D001741:Black or African American / Q000523:psychology*; D000368:Aged; D000437:Alcoholism / Q000150:complications* / Q000208:ethnology / Q000523:psychology*; D003430:Cross-Sectional Studies; D003863:Depression / Q000150:complications / Q000523:psychology; D011307:Drug Prescriptions / Q000706:statistics & numerical data*; D004636:Emergency Service, Hospital / Q000706:statistics & numerical data*; D005260:Female; D006630:Hispanic or Latino / Q000523:psychology*; D006801:Humans; D015141:Los Angeles / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D010349:Patient Compliance / Q000208:ethnology* / Q000523:psychology; D012044:Regression Analysis; D012646:Self Administration / Q000523:psychology*