MEDICATION ADHERENCE:

DEFINING THE PROBLEM

RAJIV KUMAR
B.PHARMA PRACTICE
II YEAR

RAYAT AND BAHRA UNIVERSITY,

MOHALI
 Objective
2
s
 Define medication adherence
 Explore the differences between
medication adherence and medication
compliance
 Identify associated statistics
 Factors that contribute to medication
adherence
 Why medication adherence matters?
 Introductio
3
n
 125,000 people die a year due to failure to take
medication or taking medications improperly
 Almost 6 out of 10 people are taking at least one
prescription drug
 More than 1 in 3 medicine-related hospital
admissions occur due to people not
properly adhering to their medications
 What is Medication
4
Adherence?

“The extent to which patients take

medications as prescribed by health care
providers.”
 Medication Adherence vs. Patient
5 Compliance

“Compliance suggests that the patient is passively

following the doctor’s orders and that the treatment
plan is not based on a therapeutic alliance or contract
established between the patient and the physician.”
 Medication Non-
6
Adherence
 Intentional medication non-adherence
“Active process whereby the patient
chooses to deviate from the treatment
regimen.”

 Unintentional medication non-adherence

“Passive process in which the patient may
be careless or forgetful about adhering to
treatment regimen.”
 Effects of MedicationNon-
7
Adherence
 Increased hospital readmission
 Increased disease progression and
complications
 Increased health care costs
 Decreased quality of life
 Patient death
 Patient
8
Interviews

“Taking my medication helps balance

my life. If I do not take it, I often get
sick or have emotional episodes.”
 Why Don’t Patients Take Their
9 Medicine?
Most Common Reported
Late
Refill Reasons
10%
Clinical
Question Missed
s 15% Dose
39%
High
Cost
16%
Late
Renewal
20%
 5 Dimensions of Medication
10
Adherence
 Clinical Case
11
Study
 Primary source
 48 year old African American male with low
socioeconomic status presenting myocardial
infarction and end-stage renal disease
 Assessment of medication adherence behaviors
 Psychological screening
 Questionnaires
 Post-discharge phone interview
 Electronic pill bottle
 Post-Discharge
12
Report
Measures Details Results
Barriers to adherence Asks whether Rx were filled No barriers self-reported
, and if not, reasons
why not

Morisky scale 8 item self-report 2/8 score

medication adherence scale

Modified CARDIA scale For each medication, 7/7 for all medications
self- reported # of days
in week meds were
taken
Electronic pill bottle # of days pill bottle was Aspirin 6/31
opened, divided by total # Statin 3/31
of days monitored B-blocker 2/31
Clopidogrel 0/31
 Study
13
Results
 Limitations to medication adherence for Mr. P
 Low socioeconomic status
 Lived alone
 Distrust in medications efficacy
 Belief medications being overused
 Outcomes
 Hypertension poorly controlled
 Intermittent chest pain
 Progression of coronary artery disease concern
 Summar
14
y
 What medication adherence is
 Significance of adhering to medications
 Barriers to proper medication adherence
 Pharmacists and MTM services
 Health outcomes and pharmacy
administrators