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Patients’ perceptions of their “most” and “least” important medications: a retrospective cohort study

Amy Linsky12345* and Steven R Simon12345

Author affiliations

1 Section of General Internal Medicine, VA Boston Healthcare System, 150 S. Huntington Ave, Boston, MA, 02130, USA

2 Section of General Internal Medicine, Boston Medical Center, 801 Massachusetts Ave, Boston, MA, 02118, USA

3 Boston University School of Medicine, Boston, USA

4 Division of General Internal Medicine, Brigham and Women’s Hospital, Boston, USA

5 Harvard Medical School, Boston, MA, USA

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Citation and License

BMC Research Notes 2012, 5:619  doi:10.1186/1756-0500-5-619

Published: 2 November 2012



Despite benefits of adherence, little is known about the degree to which patients will express their perceptions of medications as more or less important to take as prescribed. We determined the frequency with which Veteran patients would explicitly identify one of their medications as “most important” or “least important.”


We conducted a retrospective cohort study of patients from ambulatory clinics at VA Boston from April 2010-July 2011. Patients answered two questions: “Which one of your medicines, if any, do you think is the most important? (if none, please write ‘none’)” and “Which one of your medicines, if any, do you think is the least important? (if none, please write ‘none’).” We determined the prevalence of response categories for each question. Our cohort of 104 patients was predominantly male (95%), with a mean of 9 medications (SD 5.7). Regarding their most important medication, 41 patients (39%) identified one specific medication; 26 (25%) selected more than one; 21 (20%) wrote “none”; and 16 (15%) did not answer the question. For their least important medication, 31 Veterans (30%) chose one specific medication; two (2%) chose more than one; 51 (49%) wrote “none”; and 20 (19%) did not directly answer the question.


Thirty-five percent of patients did not identify a most important medication, and 68% did not identify a least important medication. Better understanding of how patients prioritize medications and how best to elicit this information will improve patient-provider communication, which may in turn lead to better adherence.

Communication; Adherence; Veterans; Quality of care; Patient safety