Patient-reported underuse of prescription medications: a comparison of nine surveys

UMMS Affiliation

Department of Medicine, Division of Geriatric Medicine; Meyers Primary Care Institute

Publication Date


Document Type



Adolescent; Adult; Aged; Drug Prescriptions; Female; Health Care Surveys; Health Services Misuse; Health Status; Humans; Insurance Coverage; Male; Middle Aged; Patient Compliance; Self Administration; Social Class; United States


Health Services Research | Primary Care


Nine national surveys documenting patient underuse of prescription medications were examined to describe the variation and trends in that underuse and identify possible reasons for the substantially different rates that were reported. Underuse includes unfilled prescriptions, delayed therapy, reduced frequency, and lowered dosage. Rates of cost-related patient underuse in the studies ranged from 1.6 to 22 percent. Insurance coverage, level of wealth, age, and health status were the sociodemographic variables most strongly related to underuse. Seven additional factors in the design and administration of the surveys were identified as providing plausible explanations for the variance across surveys. The most conspicuous variation was between three government-sponsored periodic surveys and six generally one-time assessments, with the latter yielding higher rates and greater variance in underuse. Understanding the factors contributing to the variation in reported rates of underuse of medications is an important prerequisite for the design of effective prescription-drug benefit programs.

DOI of Published Version



Med Care Res Rev. 2006 Aug;63(4):427-46. Link to article on publisher's site

Journal/Book/Conference Title

Medical care research and review : MCRR

Related Resources

Link to Article in PubMed

PubMed ID