CoChat
Sign Up
Cited by 138Medication Adherence and ComplianceEconomic and Financial Impacts of CancerPharmaceutical Economics and Policy

A conceptually based approach to understanding chronically ill patients’ responses to medication cost pressures

Piette, John D., Heisler, Michele, Horne, Robert, Caleb Alexander, G.·2006·Social Science & Medicine
DOI 10.1016/j.socscimed.2005.06.045
Open this paper in CoChat — free account

Abstract

Prescription medications enhance the well-being of most chronically ill patients. Many individuals, however, struggle with how to pay for their treatments and as a result experience problems with self-care and health maintenance. Although studies have documented that high out-of-pocket costs are associated with medication non-adherence, little research on prescription cost sharing has been theoretically grounded in knowledge of the more general determinants of patients' self-management behaviors and chronic disease outcomes. We present a conceptual framework for understanding the influence of patient, medication, clinician, and health system factors on individuals' responses to medication costs. We review what is known about how these factors influence medication adherence, identify possible strategies through which clinicians, health systems, and policy-makers may assist patients burdened by their medication costs, and highlight areas in need of further research. Although medication costs represent a burden to chronically ill patients worldwide, most patients report using their medication as prescribed despite the costs, and others report cost-related underuse despite an apparent ability to afford those treatments. The cost-adherence relationship is modified by contextual factors, including patients' characteristics (e.g., age, ethnicity, and attitudes toward medications), the type of medications they are using (e.g., the complexity of dosing and the drug's clinical target), clinician factors (e.g., choice of first-line agent and communication about medication costs), and health system factors (e.g., efforts to influence clinicians' prescribing and to help patients apply for financial assistance programs). Understanding these relationships will enable clinicians and policy-makers to better design pharmacy benefits and assist patients in taking their medication as prescribed. The next generation of studies examining the consequences of prescription drug costs should expand our knowledge of the ways in which these co-factors influence patients' responses to medication cost pressures.

Integrity signals

Registry

Crossref · 10.1016/j.socscimed.2005.06.045

Cites

127 of 127 references verified0 citation errors · 0 not checkable

Statistics

Recomputing p-values needs the paper’s full text.

Claims the paper makes

We couldn’t retrieve this paper’s full text, so its claims and self-check weren’t run. The registry and citation checks still apply.

Claims other papers make about this one

Each is checked against this paper’s own text: does it say what the citing paper says it does?

  • Interconnectivity between the WHO dimensions is an important aspect of medication adherence, supported by a number of conceptual frameworks but missing or not fully considered in others.

    “A white rim surrounding the five dimensions of medication adherence serves to signify the interconnectivity between the dimensions, an important aspect of medication adherence supported by a number of conceptual frameworks11, 42, 66, 85 but were missing or not fully considered in others.50, 69, 115”

    From An Adaptable Framework for Factors Contributing to Medication Adherence: Results from a Systematic Review of 102 Conceptual Frameworks (2021) · cites this paper as [42]

Cites

Flagged first, then by citations

3 of the 130 references couldn’t be matched to a known paper.

Cited by

Sorted by citations

Related

Authors
Piette, J. D., Heisler, M., Horne, R., & Caleb Alexander, G.
Affiliations
  • University of Michigan (US)
  • University of Brighton (GB)
Corresponding author
Piette, John D.
ORCID
Venue
Social Science & Medicine
Publisher
Elsevier BV
Published
2006-02
Volume
62
Issue
4
Pages
846-857
ISSN
0277-9536 (ISSN-L)
DOI
10.1016/j.socscimed.2005.06.045
OpenAlex
W1977087539
Cited by
138
References
130
Citations by year
2026: 1 · 2025: 5 · 2024: 7 · 2023: 4 · 2022: 6 · 2021: 5 · 2020: 7 · 2019: 8 · 2018: 5 · 2017: 5 · 2016: 1 · 2015: 9 · 2014: 7 · 2013: 13 · 2012: 13
FWCI
0.54
Type
journal article
Language
en
Open access
closed
Licence
www.elsevier.com/tdm/userlicense/1.0/ (tdm)
Locations
  • Social Science & Medicine (publishedVersion)
  • PubMed (publishedVersion)
  • RePEc: Research Papers in Economics (submittedVersion)
  • UCL Discovery (University College London) (submittedVersion)
Funders
World Health Organization
Topics
  • Health Sciences › Medicine › Family Practice › Medication Adherence and Compliance
  • Social Sciences › Economics, Econometrics and Finance › Economics and Econometrics › Economic and Financial Impacts of Cancer
  • Social Sciences › Economics, Econometrics and Finance › Economics and Econometrics › Pharmaceutical Economics and Policy
Keywords
prescription drug costs, medication adherence, cost-related nonadherence, chronic disease, self-management, out-of-pocket costs, cost sharing, pharmacy benefits, financial assistance programs, health system factors, conceptual framework
MeSH terms
Chronic Disease, Financing, Personal, Humans, Patient Compliance, Physician-Patient Relations, Prescription Fees, Self Care, Treatment Refusal, Drug Costs, Cost of Illness

About these checks

Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.

Statistics and arithmetic are recomputed, not judged.

Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.

What counts as a claim ›How we measure confidence ›How we check this ›

Are you an author, or do you see a problem with this page? Request a review