MEDICATION ADHERENCE

PRESENTED BY :-AARATI RATHOD, UMAIMA RINDE ,MANASI MANKAR & SWARUPA

GHARAT.
PRN.NO :-40, 31,12,15
SUB:- PHARMACY PRACTICE
RAIGAD COLLEGE OF PHARMACY
CONTENT
Introduction
Importance of medication adherence
Causes of medication non-adherence
Pharmacist role in the medication adherence
Behavioral and psychosocial approaches for medication adherence
Eight steps to improve medication adherence
Monitoring of patient medication adherence
INTRODUCTION
• Doctors assume that when they give a prescription to a patient, the drug will be taken, as directed.
• In many of the cases, patients do not follow the instruction regarding prescribed drugs and results into
no therapeutic response to given prescribed drugs which indicate poor compliance.
Hippocrates, Decorum:
• Medication adherence is more than just taking your medication.
• There are three specific terms that can be associated with medication adherence.
Adherence:
• The patient's conformance with the provider's recommendation with respect to timing, dosage and
frequency of medication.
Compliance:
• How well the patient follows the instructions of when and how to take the medication.
Persistence:
• How well the patient continues their medication regimen
The U.S. Food and Drug Administration (FDA) states,
• “Medication adherence”, or taking medications correctly, is
generally defined as the extent to which patients take medication as
prescribed by their doctors.
• This involves factors such as getting prescriptions filled,
remembering to take medication on time, and understanding the directions.
IMPORTANCE OF MEDICATION ADHERENCE

There are many situations in clinical practice where adherence is extremely

important for better therapeutic outcomes. These include :
• Chronic diseases: such as diabetes and hypertension.
• Maintenance of pharmacological effect: antihypertensive and oral hypoglycemic agents.
• Maintenance of serum drug concentration to control a particular disorder.
e.g. anticonvulsants.
Adherence consists of three essential factors:
• Patient (individual health literacy and involvement in the treatment decision process).
• Provider (the decided prescription drug regimens and corresponding communication
barriers)
• Health care system (access to care, time allotted for visits)
 CAUSES OF MEDICATION NON-ADHERENCE

• Non-adherences to drug therapy are very common phenomenon

in all patients.
• Adherence is a key factor associated with the effectiveness of
all pharmacological therapies but is particularly critical for
medications prescribed for chronic conditions. 
• The factors which contribute in non- compliance/non-adherence
may come from external source or patient experience.
PHARMACIST ROLE IN THE MEDICATION
ADHERENCE
• While medication dispensing is the best-known function of the pharmacist, pharmacists through
counseling, medication therapy management (MTM), disease-state management, and other mean
scan play a pivotal role in patient care.
• Education, while helpful, is usually not enough to persuade the patient to comply with the
physician’s drug orders.
• Information must be presented in clear, easy-to-understand language, and the patient must
understand not only the benefits of adherence, but the repercussions of nonadherence.
• Offering patient's compliance aids like; patient information leaflets, etc. to assist them in adhering
to their therapy.
• Talking with patients about refilling about drugs in pharmacy.
• Advising patients to carry a personal medication record (PMR) and develop a relationship with
their pharmacist to help with medication therapy adherence.
• Provide written instructions for each change in medication dose or frequency.
The information that patients need to know which pharmacists can impart includes:
• Name and purpose of the drug.
• When and how to take the medication.
• Possible side effects.
• Precautions.-Interaction with food or other drugs.
• Duration of therapy.
Strategies to improve the pharmacist-patient relationship:
• Be friendly and approachable to the patient.
• Improve communication skills.
• Improving patient education.
• Encourage the patient to discuss there main concern without interruption(or) pre mature
closing.
• Give clear explanation
Behavioral and Psychosocial Approaches for Medication
Adherence
• Provide positive support to encourage adherent behaviors during preparation for
transplant.
• Encourage patient to demonstrate a track record of medication adherence and
knowledge.
• Encourage individual team members to develop Sympathy and Empathy with
patient.
• Identify and involve a backup support system (family or friends).
• Treat depression, anxiety or other psychological issues.
• Elicit a personal promise of adherence (e.g. a written contract).
• Address social problems such as; insurance changes or difficulties at school or work.
 Eight Steps to Improve Medication Adherence

1. Consider medication non-adherence first as the reason a patient's condition is

not under control.
2. Develop a process for routinely asking about medication adherence.
3. Create a blame free environment to discuss medications with the patient.
4. Identify why the patient is not taking their medicine.
5. Respond positively and thank the patient for sharing their behavior.
6. Tailor the adherence solution to the individual patient.
7. Involve the patient in developing their treatment plan.
8. Set patients up for success.
MONITORING OF PATIENT MEDICATION ADHERENCE

• Full adherence to medication is required as the drug can be effective only when it is
taken.
• In general, two key factors should be considered when discussing medication adherence.
The first factor :-
• Monitoring,
• Assessment,
• Quantification,
• Measurement or evaluation.
The second factor :-
• Intervention (improving adherence to medication).
Methods that have been utilized for measuring medication adherence divided into two
categories:
• Direct and Indirect.
The direct measurement includes:-
• Drug monitoring
• Detection of the drug or its metabolites in biological fluid direct observation therapy.
The Indirect measurement includes :-
• Self reports, pill counts,
• Rates of prescription refills,
• Assessment of the patient's clinical response.
Each category comes with benefits and limitations at the same time.
• Direct measures are accurate, and they are usually expensive.
• In comparison, indirect methods are less expensive and provide good estimation of the medication
adherence.
• As Such, these factors should be taken into consideration when selecting the adherence
measurement methodology.
REFERENCE
• pharmacy practice of nirali prakashan by sourabh kosey from 7th sem.
final year b pharm.
• https://
www.slideshare.net/rameshganpisetti/medication-adherence-93414237
• https://www.uspharmacist.com/article/the-pharmacists-role-in-
medication-adherence
• https://
www.slideshare.net/SubhashR10/medication-adherence-238673990
“Drugs don’t work in patients who don’t take them.”
THANK YOU…