title: Characterizing weekly self-reported antihypertensive medication nonadherence across repeated occasions.
abstract: BACKGROUND
  Little is known about weekly variability in medication nonadherence both between and within persons.
  
  
  OBJECTIVE
  To characterize medication nonadherence across repeated, closely spaced occasions.
  
  
  METHODS
  This prospective cohort study comprised four unannounced telephone assessment occasions, each separated by approximately 2 weeks. On each occasion, adult outpatients taking at least a single antihypertensive medication completed a measure of extent of, and reasons for, nonadherence.
  
  
  RESULTS
  Two hundred and sixty-one participants completed 871 (83%) of 1,044 occasions. Nonadherence was reported on 152 (17.5%) of 871 occasions by 93 (36%) of 261 participants. The most commonly endorsed reasons for nonadherence were forgetting (39.5%), being busy (23.7%), and traveling (19.7%). Among 219 participants completing at least three occasions, 50% of the variability in extent of nonadherence was a result of within-person fluctuations, and 50% was a result of between-person differences.
  
  
  CONCLUSIONS
  Interventions to reduce nonadherence should be informed by variability in the extent of nonadherence and specific reasons for nonadherence.
authors.affiliation: Health Services Research and Development, Durham Veterans Affairs Medical Center, NC, USA ; Department of Medicine, Duke University, NC, USA.
authors.forename: Corrine I
authors.initials: CI
authors.lastname: Voils
authors.affiliation: Health Services Research and Development, Durham Veterans Affairs Medical Center, NC, USA.
authors.forename: Heather A
authors.initials: HA
authors.lastname: King
authors.affiliation: Health Services Research and Development, Durham Veterans Affairs Medical Center, NC, USA ; Department of Medicine, Duke University, NC, USA.
authors.forename: Brian
authors.initials: B
authors.lastname: Neelon
authors.affiliation: Department of Psychology and Neuroscience, Duke University, NC, USA.
authors.forename: Rick H
authors.initials: RH
authors.lastname: Hoyle
authors.affiliation: Department of Health Policy and Management, University of North Carolina at Chapel Hill, NC, USA.
authors.forename: Bryce B
authors.initials: BB
authors.lastname: Reeve
authors.affiliation: Health Services Research and Development, Durham Veterans Affairs Medical Center, NC, USA ; Department of Medicine, Duke University, NC, USA.
authors.forename: Matthew L
authors.initials: ML
authors.lastname: Maciejewski
authors.affiliation: Health Services Research and Development, Durham Veterans Affairs Medical Center, NC, USA ; Department of Medicine, Duke University, NC, USA.
authors.forename: William S
authors.initials: WS
authors.lastname: Yancy
keywords: adherence; compliance; hypertension; intraindividual variability