Aston University, A Life and Health Sciences school in Birmingham, England, as released a study on Medication Adherence, (called AMAS) which they view as a breakthrough because, until now, there seems not to have been a study that focuses on lower income patients which is broken down by ethnic and cultural and socioeconomic groups. The AMAS is such a study.

There seems to be some divergence from what we might find in a U.S. research study. Where the U.S. studies show that patients are likely to be adherent by about 50%, the AMAS study seems to find that patients there are adherent at levels closer to 66% most of the time, though the number of medications seems to be closer to half, which is similar to the data for the U.S. Ultimately, however, it all boils down to communication and understanding between the prescriber and his patient.

The areas of comparison are in cultural and language barriers. The AMAS study shows that their most difficult areas, for example, are with patients who don’t speak English well and may have a hard time understanding the consequences of not taking their medications as prescribed. It is also perceivable that the patients might be somewhat suspicious as they are often uneducated and from Pakistan. The lack of ability to communicate with this patient base might lead to a breakdown in the medical necessity for adherence. The University study has identified this and other socioeconomic groups for follow-up studies and interventions, including groups by postal code, patients younger than 60 years of age, those within certain language groups, etc. The study recommends that certain of these characteristics be coded on patient forms so that the healthcare community might be able to search, based on demographics, for persons likely to receive benefits from communications regarding medication adherence.

You can download the  by clicking here, and then following a link at the bottom of the page.
My guess is that by attempting to collect much of this information many of the patients who might derive the most benefit might also be the most alienated just by asking.

Ultimately, the question of adherence is most often answered by good and regular communication.