Patient expression of complaints and adherence problems with medications during chronic disease medical visits

The purpose of this paper was to examine: (1) to what extent do patients express complaints and adherence problems with their medication regimens during medical encounters?, (2) do specific patient and physician characteristics influence patient expression of complaints and adherence problems with continued medication regimens?, and (3) to what extent do physicians change patients' medication regimens after patients express complaints and adherence problems with their medication regimens? A data set of audio-tapes and transcripts of 467 outpatient visits as well as post-visit interviews with these chronic disease patients and their 118 primary care physicians was analyzed. The data set was originally collected during 1985-1986. Patients were on an average of 3.9 continued medications. Twenty-one percent of patients expressed one or more complaints about their medications. Logistic regression techniques showed that patients were significantly more likely to express complaints about their medication regimens if they rated their physical health more poorly (p <.05). Patients also were significantly more likely to express complaints about their medication regimens to younger physicians (p <.05). Fifty-seven percent of the time the physicians changed a patient's medication regimen after a patient complained about it. Twenty percent of patients expressed one or more adherence problems with their medications. Patients who expressed one or more complaints about their medication regimen were twice as likely to express an adherence problem than patients who did not express a complaint about their medication regimen (p <.05). Almost 45 percent of the time physicians changed a patient's medication regimen after a patient expressed an adherence problem.