Ritesh Malviya
Independent Researcher
Delhi, India
Abstract
Prescription abandonment, defined as the failure to retrieve a prescribed medication from the pharmacy, poses a significant challenge in chronic disease management. Despite clinical advances and widespread access to therapeutic regimens, a substantial percentage of patients never initiate treatment. This phenomenon undermines disease control, increases the risk of complications, and inflates long-term healthcare costs. The present study investigates behavioral and psychological drivers contributing to prescription abandonment among patients with chronic conditions such as hypertension, type 2 diabetes, and hyperlipidemia. Drawing upon a multidisciplinary review and a mixed-method approach, the research explores the roles of patient health beliefs, perceived disease severity, medication cost perception, health literacy, and provider-patient communication. Key findings indicate that psychological inertia, mistrust in medication efficacy, fear of side effects, and low perceived need for immediate treatment are primary contributors. The study highlights the need for targeted behavioral interventions, improved patient counseling, and pharmacist-led follow-ups to mitigate this issue.
Keywords
Prescription abandonment, chronic disease, behavioral drivers, patient adherence, health literacy, medication non-initiation, psychological inertia, patient perception, pharmacist intervention, disease management
References
- Bailey, S. C., Oramasionwu, C. U., & Wolf, M. S. (2013). Rethinking adherence: A health literacy–informed model of medication self-management. Journal of Health Communication, 18(Suppl 1), 20–30. https://doi.org/10.1080/10810730.2013.825672
- Fischer, M. A., Stedman, M. R., Lii, J., Vogeli, C., Shrank, W. H., Brookhart, M. A., & Weissman, J. S. (2010). Primary medication non-adherence: Analysis of 195,930 electronic prescriptions. Journal of General Internal Medicine, 25(4), 284–290. https://doi.org/10.1007/s11606-010-1253-9
- McHorney, C. A., Schousboe, J. T., Cline, R. R., & Weiss, T. W. (2011). The impact of predictive factors on medication nonadherence in adults with chronic disease. Clinical Therapeutics, 33(11), 1797–1809. https://doi.org/10.1016/j.clinthera.2011.09.021
- Shrank, W. H., Hoang, T., Ettner, S. L., Glassman, P., Nair, K., DeLapp, D., & Asch, S. M. (2006). The implications of choice: Prescribing generic or preferred pharmaceuticals improves medication adherence for chronic conditions. Archives of Internal Medicine, 166(3), 332–337. https://doi.org/10.1001/archinte.166.3.332
- Zullig, L. L., Bosworth, H. B., & Jeffreys, A. S. (2013). Patient education and counseling to improve adherence to antihypertensive medication. Patient Education and Counseling, 90(1), 37–43. https://doi.org/10.1016/j.pec.2012.08.028
- Eaddy, M. T., Cook, C. L., O’Day, K., Burch, S. P., & Cantrell, C. R. (2012). How patient cost-sharing trends affect adherence and outcomes. Pharmacy and Therapeutics, 37(1), 45–55. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3278192/
- Tamblyn, R., Eguale, T., Huang, A., Winslade, N., & Doran, P. (2014). The incidence and determinants of primary nonadherence with prescribed medication in primary care: A cohort study. Annals of Internal Medicine, 160(7), 441–450. https://doi.org/10.7326/M13-1705
- Bailey, J. E., Wan, J. Y., Tang, J., Ghani, M. A., Cushman, W. C., & Ray, M. M. (2010). Antihypertensive medication adherence, prescription claims, and blood pressure control among low-income patients. American Journal of Medicine, 123(8), 748–756. https://doi.org/10.1016/j.amjmed.2010.02.032
- Lauffenburger, J. C., Robinson, J. G., Oramasionwu, C., & Fang, M. (2014). Racial differences in statin adherence following a myocardial infarction: A retrospective cohort study. Journal of the American Heart Association, 3(5), e001577. https://doi.org/10.1161/JAHA.114.001577
- Viswanathan, M., Golin, C. E., Jones, C. D., Ashok, M., Blalock, S. J., Wines, R. C., … & Lohr, K. N. (2012). Interventions to improve adherence to self-administered medications for chronic diseases in the United States: A systematic review. Annals of Internal Medicine, 157(11), 785–795. https://doi.org/10.7326/0003-4819-157-11-201212040-00538