Patient Perspectives on Short-Course Pharmacotherapy: Barriers and Facilitators to Medication Adherence

J Patient Exp. 2020 Oct;7(5):726-733. doi: 10.1177/2374373519882230. Epub 2019 Oct 23.


Background: Medication nonadherence is a public health issue that contributes to poor health outcomes and health-care costs. Factors influencing long-term medication adherence are known; however, little is known about short-course medication adherence.

Objective: This study examined patient perspectives on adherence and factors that influence adherence to short-course pharmacotherapy in diarrhea-predominant irritable bowel syndrome.

Method: Twenty-seven participants were interviewed to identify their perceptions of barriers and facilitators to thrice-daily, 14-day rifaximin.

Results: Participants were primarily female (89%), aged 18 to 65 years. Sixty-eight percent of interviewees were identified as "low-adherers," meaning the percentage of days with correct daily dosing of rifaximin was <80%. The final coding framework identified social/economic-related (family support and medication expense), system-related (relationship with provider and medication knowledge), condition-related (symptom severity), therapy-related (inconvenient dosing), and patient-related (forgetfulness and busyness of daily life) factors that influenced adherence.

Conclusion: The resulting patient perspectives highlight a diverse set of factors that influence short-course adherence and the need for tailored interventions that address these various factors resulting in enhanced patient outcomes.

Keywords: irritable bowel syndrome; medication adherence; patient perspectives/narratives; short-course pharmacotherapy.