Patient Medication Adherence: Measures in Daily Practice
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Medication adherence is defined by the World Health Organization as "the degree to which the person’s behavior corresponds with the agreed recommendations from a health care provider."

Medication non-adherence in patients leads to a substantial worsening of the disease, death, and increased health care costs. Identifying specific barriers for each patient and adopting suitable techniques to overcome them will be necessary to improve medication adherence.

What are the various types of medication non-adherence?

--> Primary non-adherence; in which providers write a prescription but the medication is never filled or initiated.
--> Non-persistence; in which patients decide to stop taking medication after starting it, without being advised by a health professional to do so.
--> Non-conforming; in which medication is not taken as prescribed, this behavior can range from skipping doses, to taking medications at incorrect times or at incorrect doses, to even taking more than prescribed.

What can you do to improve medication adherence?

1. Introduce a collaborative approach with your patient at the level of prescribing.

Whenever possible, involve patients in decision making regarding their medications so that they have a sense of ownership and they are partners in the treatment plan. Use the most possible simplified regimen based on patient characteristics at the first level of drug use.

2. Communicate with your patient

Explain key information when prescribing/ dispensing a medicine (what, why, when, how, and how long); Inform the common side effects and those that patient should necessarily know (Patients would be more worried and lead to non-adherence due to side effects that were not cautioned to them in advance by health care professionals)

3. Use medication adherence improving aids

Provide medication calendars or schedules that specify the time to take medications, drug cards, medication charts or medicine related information sheets or specific packaging such as pill-boxes, ‘unit-of-use’ packaging, and special containers indicating the time of dose.

4. Provide behavioral support

Collaborate with a patient to incorporate the medication regimen into his/her daily regimen (essential in those on complex drug regimens, those having unintentional difficulties in adherence e.g. elderly)

5. Schedule appropriate follow up

Monitoring the medication adherence should also be criteria while scheduling patient follow up; Check the effectiveness of medication adherence aids used, if any.

6. Identify difficulties and barriers related to adherence

Address the problems; Inform the patients accordingly how the problems have been addressed

Patient medication non-adherence is a major medical problem globally. Though patient education is the key to improving compliance, the use of compliance aids, proper motivation, and support is also shown to increase medication adherence. These strategies could help improve medication adherence within the limits of your practice eventually enhancing therapeutic outcomes.

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