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MARGARET E. GATTI, M.P.H., is Student, School of Medicine, George-town University, Washington, DC. KARA L. JACOBSON, M.P.H., CHES, is Senior Research Associate; JULIE A. GAZMARARIAN, PH.D., M.P.H., is Research Associate Professor; and BRIAN SCHMOTZER, M.S., is Senior Biostatistician, Rollins School of Public Health, Emory University, Atlanta, GA. SUNIL KRIPALANI, M.D., M.SC., is Associate Professor of Clinical Medicine, Center for Health Services Research, Vanderbilt University, Nashville, TN.

Address correspondence to Ms. Gatti at the School of Medicine, Georgetown University, 1080 Wisconsin Avenue, Northwest, Washington, DC 20007 (margaret.gatti{at}gmail.com).

Purpose. The relationships between beliefs about medications, health literacy, and self-reported medication adherence are examined. Methods. Patients from an inner-city hospital pharmacy completed an in-person, interviewer-assisted questionnaire that included the Morisky 8-item Medication Adherence Scale (MMAS-8), the Beliefs About Medicines Questionnaire (BMQ), and the Rapid Estimate of Adult Literacy in Medicine (REALM). Multivariable logistic regression was used to determine predictors of self-reported medication adherence as determined by the MMAS-8. Variables included in the model were summary scores from the BMQ, REALM, and patient or regimen characteristics that were significantly associated with the MMAS-8. Results. A majority of the 275 study participants were African-American (86.2%), were women (73.1%), and could read at less than a high school reading level (59.7%). The average age was 53.9 years. Approximately half of the patients (52.7%) reported low medication adherence (MMAS-8 score of >2). Multivariate analyses indicated several factors were associated with low self-reported adherence, including negative beliefs about medications, younger age, low medication self-efficacy, and hyperlipidemia. Health literacy was not independently associated with beliefs or adherence. Conclusion. Patients who had negative beliefs about medications, who were <65 years of age, or who had low medication self-efficacy reported low medication adherence. Index terms: Age; Compliance; Data collection; Health care; Patients