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
