Fast Facts: Medication Adherence

A Practical Approach to Optimizing Medication Use

Parisa Aslani, Henry N. Young, Michelle Koo, P. Aslani, H.N. Young, M. Koo

• Publisher: S. Karger
• Year: 2021
• Print ISBN:
  9783318069921
• eBook ISBN:
  9783318069938
• Topic: Medicine
• Subtopic: Pharmacology

Helping your patients to use their medications safely and appropriately is a critical aspect of clinical practice, but it can be challenging. The published literature on the topic of adherence is vast, and constantly growing and evolving. It is not feasible, nor necessarily helpful, to comprehensively summarize all the available evidence. Instead, this book aims to provide all health professionals with a succinct and handy resource on medication adherence. Importantly, the book focuses on practical information that can inform, and be applied in, day-to-day clinical practice.

4	Interventions to support adherence

Once you have identified the underlying factor(s) contributing to your patients’ non-adherence, then you can collaborate with them to implement specific interventions that support their adherence to prescription medication regimens.

Interventions can be broadly categorized as informational or sociobehavioral.¹ Practitioners and researchers use combinations of informational and sociobehavioral interventions to support patients’ medication adherence.¹ For example, you may identify that your patient does not understand why they are taking the capsules you have prescribed, or does not know how the medication will help them. You may therefore decide that providing information and educating the patient about the purpose of the medication (informational interventions) may be the most appropriate intervention at this stage. In addition, you may tailor your patient education according to the patient’s preferences and needs (verbal or written). If you identify that a patient is forgetful or misses appointments or prescription refills, then you may implement monitoring/feedback and/or reminders (sociobehavioral interventions) to support medication adherence.

Informational interventions

Providing patients with information can be an effective means of improving adherence. The information may be about the medications they are taking or using (for example, name, dose, indication), the conditions the medications treat (for example, hypertension, diabetes), how to monitor the effectiveness of the medications, what side effects to watch for and/or what to do if any problems occur. The information can be given by physicians, nurses, pharmacists, or other allied health professionals or health educators. The information can be verbal or written.

	Verbal education can take the form of in-person consultations, group discussions or telecommunications (for example, phone and/or internet-based calls).
	Written material can be supplied as newsletters, fact cards, brochures and information leaflets, either in printed form or electronically.

Sociobehavioral interventions

Sociobehavioral interventions are strategies and tools designed to affect patients’ medication use. These interventions can use medication management, approaches based on theoretical frameworks and/or devices to support medication adherence, as outlined below.

	Monitoring and follow-up is the assessment of adherence by the health professional, providing tailored feedback to address non-adherence.
	Psychological interventions use theoretical concepts to influence patients’ medication-taking behavior. For example, strategies can seek to improve a patient’s self-efficacy (belief in her/his own ability to perform a behavior) to adhere to prescribed regimens, or reinforce adherence by providing rewards and incentives that encourage medication use.^2
	Self-monitoring involves mobilizing the patient to participate in the management of their condition by actively monitoring their own medication use and/or health status, and sharing information with health professionals.
	Social support from others can bolster medication adherence. Interactions between patients and their healthcare providers, families and friends can help patients to better understand their conditions and medications, as well as reminding and encouraging patients to take their medications.
	Family therapy is the counseling of family members to help improve communication and provide conflict resolution (for example, discord between an adolescent’s need for autonomy and the parents’ need for stability). Family therapy can help patients and family members cope with chronic conditions and can be used to address family situations that cause stress, grief, conflict and/or anger.
	Regimen simplification can be an effective means...

Table of contents

• Cover
• Title Page
• Copyright
• Contents
• Introduction
• Terminology and definitions
• Epidemiology
• Identifying non-adherence
• Interventions to support adherence
• Useful resources
• Index