Mapping the Construct/ Construct Mapping

Medication non-compliance, or failing to take prescribed medication consistently or correctly, is an ongoing issue among patients and can lead to serious health problems if unaddressed. Often, medical professionals blame the patient for this, seeing it as a choice the patient has made to not take the medication correctly. This concept map identifies Three likely pathways by which medication non-compliance can be conceptualized and addressed from a social perspective are depicted above, with all three beginning at the larger structural determinant of Education policy.

One pathway begins with education policy and runs through a lack of quality education in public schools. In turn, this leads to low health literacy which can mean difficulty understanding instructions for how and when to take medication, leading to a higher chance that someone will fail to take medication correctly.

Education policy that underfunds schools can also lead to higher dropout rates. Both dropout rates and low-quality education leads to low wage employment and these positions typically do not offer healthcare coverage. Without health insurance, the ability to afford prescribes medication or to even access a physician for treatment is reduced. The outcome is an inability to comply with any medication regime (if in fact one can be sought and obtained).

The dotted arrow between the ability to comply with medication regimen and medication compliance shows that self-efficacy moderates this relationship. That is, higher levels of self-efficacy will contribute to a stronger relationship between ability to comply and actual compliance, while low levels of self-esteem will weaken this relationship. Another moderator between the ability to comply and actual compliance is unwanted side effects. If side effects are high—or serious, the ability to comply will not be a strong predictor of compliance. If, however, there are no or few side-effects, the relationship between ability to comply and compliance will be strong.

Throughout this concept map, there are several points at which interventions can help decrease the amount of medication non-compliance:

Implementing a work-credit program to help students who would otherwise drop out of school to make money graduate with their degree.

Implement a mandatory, state-wide health education curriculum for public schools that focuses on health literacy.

Implement a ”living wage” level minimum wage.

Protect policy that requires employers to provide part-time employees with the option of health insurance

Policies that regulate the cost of pharmaceuticals or offer subsidies for medications for those who are low income.

Provide transportation to free clinics, doctor’s offices, and pharmacies.

Create support networks with physicians, nursing assistants, and other health providers to reach out to patients to remind and coach them on compliance.

Provide counseling for new diagnoses on how to recognize and deal with side effects of new medications (or ask for changes in medications).

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