The impact of cognitive function on medication management: three studies.
OBJECTIVE
Medication nonadherence has been a persistent problem over the past three decades; forgetting and being distracted from regular routines are the barriers most frequently cited by patients. Prior research on cognitive function and medication adherence has yielded mixed results.


METHODS
This report compares findings of three studies: All were longitudinal, two were randomized controlled intervention trials, and one was descriptive. Samples of adult patients taking once daily lipid-lowering medication, diabetic patients with comorbid conditions on complex regimens, and early stage breast cancer patients on hormonal therapy completed similar batteries of standardized, valid, neuropsychological tests at baseline.


METHODS
Adherence to medication regimens, over time, was tracked with electronic event monitors.


RESULTS
Medication nonadherence was prevalent in all studies. Deficits in attention/mental flexibility and/or working memory predicted nonadherence in all studies; impaired executive function was related to poor adherence in one study.


CONCLUSIONS
These findings suggest that better mental efficiency may be the key to better medication adherence with any regimen, and that targeted cognitive functions, which can be easily and quickly assessed, may identify patients at risk of poor adherence regardless of diagnosis or regimen.
Stilley
Carol S
CS
Center for Research in Chronic Disorders (CRCD), School of Nursing, University of Pittsburgh, Pittsburgh, PA, USA. css100@pitt.edu
Bender
Catherine M
CM
Dunbar-Jacob
Jacqueline
J
Sereika
Susan
S
Ryan
Christopher M
CM
D000328:Adult; D001294:Attitude to Health; D003072:Cognition Disorders / Q000175:diagnosis / Q000453:epidemiology*; D004358:Drug Therapy / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D008297:Male; D001523:Mental Disorders / Q000188:drug therapy; D008875:Middle Aged; D009483:Neuropsychological Tests; D010349:Patient Compliance / Q000706:statistics & numerical data*; D055815:Young Adult