The Relationship Between COVID-19 Related Stress and Medication Adherence Among High-Risk Adults During the Acceleration Phase of the US Outbreak

Abstract

Purpose

To assess the relationship between stress regarding COVID-19 and medication adherence.

Patients and Methods

Older adults with ≥1 chronic condition(s) were recruited from 4 active, federally funded studies in Chicago to participate in a longitudinal telephone survey. Participants self-reported stress regarding COVID-19 in the last week. Adherence was measured via the ASK-12 survey.

Results

Most participants reported feeling stressed “some of the time” (54.0%), while 18.2% felt stressed “most” or “all of the time” and 27.8% “never” felt stressed. In bivariate analyses, participants who reported being stressed “most” or “all of the time” had worse medication adherence than participants who reported being stressed “some of the time” or “never” (p < 0.001). In multivariable analyses, participants who reported feeling stressed “most” or “all of the time” had worse adherence than those who “never” felt stressed (Adjusted Least Square Mean (Standard Error): 21.3 (0.6) vs 19.7 (0.6), p=0.01).

Conclusion

Stress due to COVID-19 has significantly impacted medication adherence, which has negative implications for the course of both COVID-19 and comorbid conditions. Healthcare providers should be aware of the potential impact of COVID-19 on patients’ mental and physical well-being and consider ways to routinely assess patient experiences.

Keywords:

• COVID-19
• stress
• medication adherence
• comorbidity

Acknowledgments

We are grateful for the support of this work by grants: R01AG030611, R01AG046352, R01DK110172, and R01NR01544 of the National Institutes of Health (NIH). Research reported in this publication was also supported, in part, by the National Institutes of Health’s National Institute on Aging, Grant Number P30AG059988. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health.

Disclosure

Dr. Bailey reports grants from the NIH, Merck, Pfizer, Gordon and Betty Moore Foundation, Lundbeck and Eli Lilly and personal fees from the Sanofi, Pfizer, University of Westminster and Luto outside the submitted work. Dr. Pack reports grants from the NIH, Pfizer, Gordon and Betty Moore Foundation, Lundbeck and Eli Lilly. Dr. Wolf reports grants from the NIH, Amgen, Lundbeck, Merck, Pfizer, Gordon and Betty Moore Foundation, and Eli Lilly during the conduct of the study and personal fees from Sanofi, Pfizer, University of Westminster and Luto outside the submitted work. Miss Zhao reports grants from NIH during the conduct of the study. The authors report no other conflicts of interest in this work.