Date of Award


Document Type


Degree Name

Doctor of Occupational Therapy


Occupational Therapy

First Advisor

Tania Shearon, MOT, OTR/L, CHT

Second Advisor

Aaron Bonsall, PHD, O TR/L


Medication non-adherence has been an ongoing problematic public health issue in the United States that has resulted in negative complications such as financial expenditure, a lower quality of life, increased chronic health conditions, frequent hospital readmission, increased health care costs, morbidity, and mortality across a variety of health care conditions (CDC, 2017; Yap et al., 2016). An estimated $100-300 billion dollars is spent annually on medication adherence across the nation (CDC, 2017; Robnett et al., 2007). With costs on the rise, it has been identified that around 50% of individuals take medication incorrectly, and 14-77% actively or passively fall in the non-adherence category (CDC, 2017). Active medication non-adherence can be explained when the patient directly chooses to deviate from a medication treatment regimen, and passive non-adherence is the process in which the patient may be forgetful or negligent in adhering to a medication treatment regimen (Bryson & Rumsfeld, 2009). A number of risk factors can contribute to nonadherence. Examples of such risk factors may include the level of health literacy of the patient, medication cost, physician-patient communication/relationship, history of non-adherence, beliefs in medication, substance abuse, cognitive impairment, psychological disorders, poor social support, poor transportation, complex medication regimens, lack of medication education, poor environmental set up, lack of reminders, and number of medications (Bryson & Rumsfeld, 2009; Jimmy & Jose, 2011). It is a nation-wide issue that needs to be addressed due to the rising mortality and morbidity rates, and complications that follow for patients. The current literature has identified viable risk factors that complicate medication adherence, but gaps continue to address long term follow up in the home in order to continue prevention of hospital readmission.