Historically, medication adherence has been framed in binary terms: compliant or non-compliant. This perspective held patients solely responsible for taking their medications as prescribed1. However, this simplistic view failed to consider the complexities of human behavior and the many factors influencing medication adherence, such as socioeconomic status, mental health, access to healthcare, and cultural beliefs2, 3. In recent decades, healthcare has transitioned towards a more patient-centered approach, emphasizing the importance of understanding a patient’s values, beliefs, and preferences4. This change has caused the rise of a new term in healthcare, adherence, which emphasizes a collaborative relationship between patients and healthcare providers5. Nowadays, healthcare providers are increasingly recognizing that medication nonadherence can be influenced by factors such as generational attitudes, with each generation having distinct experiences that shape their views on healthcare6. Baby boomers, who have grown up in an era where patients were expected to place their trust in medical professionals, tend to view medication adherence differently than millennials or Gen Z, who have a wealth of knowledge at their disposal (research shows that more than a third of US adults regularly use the internet to self-diagnose themselves with illnesses7).
Several cultural shifts have played a significant role in shaping attitudes towards medication adherence6. Firstly, the rise of digital health tools, telemedicine, mobile health apps, and other advancements in technology has transformed how patients manage their medications, particularly among younger generations8. Thanks to these advancements, younger generations have had increased accessibility to health information via the internet, which has democratized health information, leading to more informed but also more skeptical patients who may question traditional medical advice9. Another shift of note is the increasing focus on holistic and preventive health approaches, which has led some to prioritize lifestyle changes over medication, impacting adherence10. The economic pressures of rising healthcare costs and economic uncertainty has been shown to negatively influence medication adherence, particularly among older adults on fixed incomes and younger adults facing financial instability11. Finally, growing cultural diversity in many societies introduces varied health beliefs and practices, requiring more culturally sensitive approaches to medication adherence12.
Addressing medication nonadherence across generations requires tailored strategies that resonate with the differing values and lifestyles13:
- Baby Boomers (1955–1964):
- Simplify medication regimens and provide clear, accessible information.
- Offer financial assistance programs to ease the cost burden.
- Foster strong relationships to maintain trust, and ensure two-way communication between patient and provider.
- Generation X (1965–1980):
- Provide comprehensive, reliable online resources to support informed decision-making.
- Use reminders and organizational tools to aid in medication management.
- Address concerns about side effects and drug interactions transparently.
- Millennials (1981–1996):
- Leverage digital health tools and telemedicine to provide convenient care.
- Emphasize the importance of adherence in achieving long-term wellness goals.
- Engage with social media and online communities to disseminate accurate health information.
- Generation Z (1997–2012):
- Integrate technology into healthcare experiences, such as through electronic pill bottles for busy schedules12.
- Offer personalized and on-demand healthcare solutions.
- Educate on the importance of adherence through engaging, bite-sized content.
Understanding the cultural and generational changes in perceptions of medication adherence is crucial for developing effective strategies to improve health outcomes. By recognizing the unique needs and attitudes of each generation, healthcare providers and the pharmaceutical industry can better support patients in managing their medications, ultimately enhancing adherence and overall health. Moving forward, healthcare providers must learn to adapt their strategies to engage patients meaningfully, fostering environments where individuals feel empowered to discuss their concerns and preferences.
References
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Whittle, Jeff, et al. “Clinical and Demographic Correlates of Medication and Visit Adherence in a Large Randomized Controlled Trial.” BMC Health Services Research, vol. 16, no. 1, 8 July 2016, https://doi.org/10.1186/s12913-016-1471-x. Accessed 29 Nov. 2020.
Xie, Zhenzhen, et al. “An Examination of the Socio-Demographic Correlates of Patient Adherence to Self-Management Behaviors and the Mediating Roles of Health Attitudes and Self-Efficacy among Patients with Coexisting Type 2 Diabetes and Hypertension.” BMC Public Health, vol. 20, no. 1, 12 Aug. 2020, https://doi.org/10.1186/s12889-020-09274-4
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WEINGARTEN, M A, and B S CANNON. “Age as a Major Factor Affecting Adherence to Medication for Hypertension in a General Practice Population.” Family Practice, vol. 5, no. 4, 1988, pp. 294–296, https://doi.org/10.1093/fampra/5.4.294. Accessed 29 Sept. 2020.
Farvid, Maryam S, et al. “Dietary Protein Sources in Early Adulthood and Breast Cancer Incidence: Prospective Cohort Study.” BMJ : British Medical Journal, 2014, dash.harvard.edu/handle/1/12406554?show=full, https://doi.org/0959-8138.
Granger, Bradi B, and Hayden B Bosworth. “Medication Adherence: Emerging Use of Technology.” Current Opinion in Cardiology, vol. 26, no. 4, July 2011, pp. 279–287, www.ncbi.nlm.nih.gov/pmc/articles/PMC3756138/, https://doi.org/10.1097/hco.0b013e328347c150.
Council, Research. “Health Applications of the Internet.” Nih.gov, National Academies Press (US), 2019, www.ncbi.nlm.nih.gov/books/NBK44714/.
Guo, Aizhen, et al. “Impact of Health Literacy and Social Support on Medication Adherence in Patients with Hypertension: A Cross-Sectional Community-Based Study.” BMC Cardiovascular Disorders, vol. 23, no. 1, 19 Feb. 2023, bmccardiovascdisord.biomedcentral.com/articles/10.1186/s12872-023-03117-x, https://doi.org/10.1186/s12872-023-03117-x
Osborn, Chandra Y., et al. “Financial Strain Is Associated with Medication Nonadherence and Worse Self-Rated Health among Cardiovascular Patients.” Journal of Health Care for the Poor and Underserved, vol. 28, no. 1, 2017, pp. 499–513, https://doi.org/10.1353/hpu.2017.0036.
Wetzels, Gwenn E C, et al. “All That Glisters Is Not Gold: A Comparison of Electronic Monitoring versus Filled Prescriptions – an Observational Study.” BMC Health Services Research, vol. 6, no. 1, 10 Feb. 2006, https://doi.org/10.1186/1472-6963-6-8. Accessed 15 May 2023.