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Medication nonadherence has been linked to health literacy and poor patient outcomes. The Health Literacy Universal Precautions Toolkit addresses both issues.A brown bag medication review was implemented to identify medication nonadherence in a Midwestern clinic.Adult patients were instructed to bring all prescribed and over-the-counter medication to office visits. A reviewer transcribed administration directions and the patient's verbal instruction of how the medication is taken.The study found 58% (n = 28) of 48 participants were nonadherent for at least 1 medication; 26% (n = 72) of all medications were nonadherent; and mental health drugs were the highest nonadherence category at 38% (n = 11). The majority of medication nonadherence was due to lack of access.This drug utilization review was found helpful in identification of causes for medication nonadherence, assisting prescribers, and improving patient education.