title: Medication adherence in a nurse practitioner managed clinic for indigent patients.
abstract: OBJECTIVE
  Little is published in the literature about medication adherence rates among patients who are medically indigent and patients receiving primary care from nurse practitioners (NPs). This project examined adherence rates and barriers to adherence among patients at an NP-managed health clinic (NPMC).
  
  
  METHODS
  The setting for this research was an NPMC for uninsured and low-income patients. A cross-sectional convenience sample of patients (n = 119) completed surveys eliciting demographic information, self-report of medication adherence, health literacy, and barriers to adherence.
  
  
  CONCLUSIONS
  Analysis of subjects demonstrated a vulnerable population, yet the mean adherence rate was surprisingly high (77%), compared to the rate usually cited in published literature. The best predictive model differentiating patients with high adherence from those with low adherence combined the total number of reported barriers, health literacy, and employment status. The barriers most frequently cited by subjects were difficulty paying for medications, and difficulty reading and understanding written prescription labels, which was particularly prevalent among Spanish-speaking patients.
  
  
  CONCLUSIONS
  Clinic efforts to improve patient access to affordable medications may have contributed to subjects' high rates of adherence. These efforts included helping patients with filling out prescription assistance program paperwork, prescribing generic medications, providing samples, and providing effective patient education.
authors: The University of Alabama, Tuscaloosa, Alabama.
authors: Suzanne
authors: S
authors: Alton
authors: The University of Alabama, Tuscaloosa, Alabama.
authors: Alice L
authors: AL
authors: March
authors: University of Texas Medical Branch, Galveston, Texas.
authors: Laura
authors: L
authors: Mallary
authors: University of Texas Medical Branch, Galveston, Texas.
authors: Kathryn
authors: K
authors: Fiandt
mesh_terms: D000328:Adult; D003710:Demography; D005260:Female; D006303:Health Services, Indigenous / Q000592:standards*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009722:Nurse Practitioners; D010349:Patient Compliance / Q000706:statistics & numerical data*; D010353:Patient Education as Topic; D011203:Poverty; D057184:Practice Patterns, Nurses'; D011795:Surveys and Questionnaires; D013781:Texas
keywords: Nurse practitioners; adherence; indigent; medications; nurse-managed clinics; practice models; vulnerable