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Medication affordability was another facilitator for lupus medication decision-making.
Patient's medication beliefs, especially perceived need for medication and perceived medication affordability, were strong predictors of unintentional non-adherence.
Patients in the lowest quartile of perceived medication affordability were 4.65 times more likely to report running out of medications at times.
The multi-item scales assessing perceived need for medications, perceived medication concerns, and perceived medication affordability have been previously tested and found to be reliable and valid [ 26].
One item each from the Adherence Estimator® assessed the domains of perceived need for medications, perceived medication concerns, and perceived medication affordability [ 26].
Respondents in the lowest quartile for perceived medication affordability scores were 2.32 times more likely than those in the highest quartile to report any unintentional non-adherence.
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Taking all of that into account, the paper's authors determined: "The ACA's first 2 open enrollment periods were associated with significantly improved trends in self-reported coverage, access to primary care and medications, affordability, and health".
After linking the emerging concepts and the 5As access to care dimensions, the following themes emerged: (i) perceptions of the chronicity of diabetes and of the acceptability of medications, (ii) affordability, (iii) accessibility, and (iv) availability and accommodation.
A hierarchical logistic regression model confirmed the significant difference between CAM users and non-users in relation to sex (males) [OR = 2.09 (1.22 – 3.58), p = 0.007] and medication un-affordability [OR = 3.7 (11.11– 11.11, p = 0.006].
Difficulties exist with regard to transportation, communications, equipment, facility infrastructure, medication supply lines, affordability and availability of skilled healthcare providers.
Important patient-identified facilitators of medication adherence included: affordability of care (through health insurance); trust in orthodox "western" medicines; trust in Doctor; dreaded dangers of hypertension; and use of prayer to support efficacy of pills.
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