title: Perceptions of and barriers to use of generic medications in a rural African American population, Alabama, 2011.
abstract: BACKGROUND
  Using generic medications for chronic diseases provides efficacy similar to that of brand-name medication use, but at a lower price, potentially enhancing adherence. However, previous studies show that disadvantaged people, who may particularly benefit from cost savings, have low trust of generics and increased reluctance to switch to generics. The rural South includes areas of high poverty and minority communities whose members are at high risk for poor health outcomes; however, whether such beliefs exist in these communities has not been reported. We sought to obtain qualitative insight into beliefs about generic medication use among African Americans in the rural South.
  
  
  METHODS
  Investigators conducted 4 focus groups with 30 community members from Alabama's Black Belt area. Transcribed discussions were analyzed and common themes identified.
  
  
  RESULTS
  Participants were primarily unemployed middle-aged women, one-fourth of whom were uninsured and more than half of whom had a high school education or less. Barriers to generic medication use included perceptions that generics are less potent than brand-name medications, require higher doses, and, therefore, result in more side effects; generics are not "real" medicine; generics are for minor but not serious illnesses; the medical system cannot be trusted; and poor people are forced to "settle" for generics.
  
  
  CONCLUSIONS
  Although education about generics could rectify misinformation, overcoming views such as mistrust of the medical system and the sense of having to settle for generics because of poverty may be more challenging. Policy makers and providers should consider these perspectives when working to increase generic drug use in these populations.
authors.affiliation: University of Alabama at Birmingham School of Medicine, 1717 11th Ave S, Ste 510D, Birmingham, AL 35233, USA. keri.d.sewell@gmail.com
authors.forename: Keri
authors.initials: K
authors.lastname: Sewell
authors.forename: Susan
authors.initials: S
authors.lastname: Andreae
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Luke
authors.forename: Monika M
authors.initials: MM
authors.lastname: Safford
mesh_terms: D001741:Black or African American / Q000523:psychology* / Q000706:statistics & numerical data; D000407:Alabama; D002908:Chronic Disease / Q000188:drug therapy*; D016568:Drugs, Generic / Q000009:adverse effects / Q000627:therapeutic use*; D005260:Female; D017144:Focus Groups; D007722:Health Knowledge, Attitudes, Practice; D006296:Health Services / Q000706:statistics & numerical data; D054624:Health Status Disparities; D006801:Humans; D019458:Insurance Coverage / Q000706:statistics & numerical data; D008297:Male; D008875:Middle Aged; D010342:Patient Acceptance of Health Care / Q000208:ethnology* / Q000706:statistics & numerical data; D010349:Patient Compliance / Q000208:ethnology; D011203:Poverty / Q000208:ethnology / Q000706:statistics & numerical data; D036301:Qualitative Research; D012424:Rural Population; D012938:Social Perception; D012959:Socioeconomic Factors; D013810:Therapeutic Equivalency; D035502:Trust / Q000523:psychology
chemical_list: D016568:Drugs, Generic