Patients' Journey to Medication Adherence (2018-2019)

Medication nonadherence is a prevalent issue worldwide and across all socioeconomic groups, yet existing intervention programs have been only moderately effective, and long-term results are often less than satisfactory. Improving patient adherence is critical in raising healthcare quality, leveling health disparities and containing costs for the individuals and the health system.

This project team worked to provide richer insights into patient psychology and cognition by: 

  • Uncovering patients’ insights and thought processes regarding illness, treatment and relationship with physicians
  • Examining health equity and cultural differences in self-perceptions and value of medication
  • Implementing a longitudinal study to capture the fluctuations of patients’ feelings and behavior related to medication and how these factors influence adherence over time.

Using Rheumatoid arthritis as a case study, team members used a mixed methods approach to explore how communication between patient and physician influenced medication-taking behavior. Through focus groups and individual interviews, team members found that patient medication-taking is a dynamic process and that targeting improved communication during office visits with physicians can promote better medication-taking behaviors. The team also found that medication adherence was influenced by fear of side effects and confusion about when (and why) adjustments in protocol were desirable or needed.

The team has two additional manuscripts in process and will continue a longitudinal study based on insights collected from the focus groups. Two of the team’s student alumni, Shweta Lodha and Christiana Oshotse (2017-2018) also have a research paper in progress with team leaders.


Summer 2018 – Summer 2019  

Team Outputs

Cheryl Lin, Rachel Clark, Pikuei Tu, Rungting Tu, Ya-Jung Hsu, Hsiao-Ching Nien. 2019. “The disconnect in hepatitis screening: participation rates, awareness of infection status, and treatment-seeking behavior.” Journal of Global Health 9(1)

Patient-Physician Communication and Medication-Taking Behaviors of Rheumatoid Arthritis Patients (poster by Ian Levitan, Hayden Bosworth, Cheryl Lin, Pikuei Tu, Leah Zullig, presented at Bass Connections Showcase, Duke University, April 17, 2019)

2018 Duke Health Forum: Health Equity MattersWhat Has Worked?, August 27, 2018

This Team in the News

“Invisible” Illnesses: Exploring Medication Adherence from the Patient’s Perspective

See earlier related team, Patients’ Journey to Medication Adherence (2017-2018).

Health worker holding prescription pills

Team Leaders

  • Hayden Bosworth, School of Medicine-Psychiatry and Behavioral Sciences
  • Cheryl Lin, John Hope Franklin Center, Duke Policy and Organizational Management Program, Markets and Management Studies, International Studies
  • Pikuei Tu, John Hope Franklin Center, Duke Policy and Organizational Management Program, Markets and Management Studies, International Studies
  • Leah Zullig, School of Medicine-Population Health Sciences

/undergraduate Team Members

  • Carolyn Huynh, Neuroscience (BS)
  • Ian Levitan, Biology (BS)
  • En-Hua Wang, Neuroscience (AB)

/zcommunity Team Members

  • Laura Bayzle, The Link Group
  • Rachel Clark, RTI International
  • Rungting Tu, Management School, Shenzhen University, China