Self-administered nutritional supplement nenadherence by prenatal patients.

The purpose of this study was to determine the non-adherence by prenatal patients to their regularly prescribed vitamin and iron supplements. An additional intent of the study was to identify factors that may lead to or help explain non-adherent behavior. Data were collected at Hill Air Force Base Hospital during a non-consecutive 13-week period. The sample consisted of 36 prenatal patients who attended the prenatal clinic orientation briefings at the Air Force Hospital. These subjects met the established criteria, consented to participate in the study and then returned for the follow-up visit. All prenatal patients received routine prescriptions for nutritional supplements with instructions and no change was made for study subjects. The vitamin and iron dosage non-adherent rates were determined by the ratio of errors to the number of doses the patient would have taken either on the 12th or 14th day after their prescription was filled. The number of errors was determined at the follow-through interview after counting the pills remaining in the prescription bottles. Statistical data indicated that prenatal patients had a 36% iron dosage non-adherence and a 25% vitamin dosage non-adherence. There were statistically significant variables associated with increased non-adherent behavior. Patients tended to be more non-adherent if they (1) admitted mission one or more of their prescribed doses; (2) denied counterbalancing an error or dosage omission one time with two pills at a later time; and (3) either forgot to take their pills at work of the pills gave them gastro-intestinal upset. The clinical significance of these findings suggest that in order to increase iron dosage adherence, the professional may consider prescribing iron supplementation only during the latter half of pregnancy to normal uncomplicated prenatal patents when the physiological gastro-intestinal disturbances are usually alleviated. At that time the number of iron doses prescribed should be reduced to a minimum of one or two a day and avoid unnecessarily high dosages of elemental iron to be absorbed at one time. Problems and concerns noted during the study were discussed as well as recommendations and implications for future research in this area.