Question

How many percentages of patients can maintain satisfactory medication administration levels and control after patient education? Using the clinical question you identified from above, determine the individual components to that question and pinpoint the location in the hypothetical database where the information you require will be extracted.

Answer 1

Adherence to therapies is a primary determinant of treatment success. Failure to adherence is a serious problem which not only affects the patient but also the health care system. Medication non adherence in patients leads to substantial worsening of disease, death and increased health care costs. A variety of factors are likely to affect adherence. Barriers to adherence could be addressed as patient, provider and health system factors, with interactions among them. Identifying specific barriers for each patient and adopting suitable techniques to overcome them will be necessary to improve medication adherence. Health care professionals such as physicians, pharmacists and nurses have significant role in their daily practice to improve patient medication adherence.

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."Though the terms adherence and compliance are synonymously used adherence differs from compliance.

There are several types of non adherence but most often the categorization is indisputable, and there is a degree of overlap. The first is known as primary non adherence, in which providers write prescription but the medication is never filled or initiated. This type is commonly called non fulfillment adherence.9

A second type of non adherence is called non persistence in which patients decide to stop taking a medication after starting it, without being advised by a health professional to do so. Non persistence is rarely intentional and happens when patients and provider miscommunicationout therapeutic plans. Unintentional non adherence arises from capacity and resource limitations that prevent patients from implementing their decisions to follow treatment recommendations (e.g. problems of accessing prescriptions, cost, competing demands etc) and sometimes involves individual constraints

A third type of non adherence is known as non conforming, this type includes a variety of ways in which medication are 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.

Non-adherence is a very common phenomenon in all patients with drug taking behavior. Complexity of adherence is the result of an interplay of a range of factors including patient views and attributes, illness characteristics, social contexts, access and service issues.

Methods to improve medication adherence

The effectiveness of a treatment depends on both the efficacy of a medication and patient adherence to the therapeutic regimen. Patients, health care providers, and health care systems, all have a role to improve medication adherence. A single method cannot improve medication adherence, instead a combination of various adherence techniques should be implemented to improve patient’s adherence to their prescribed treatment.

Patient medication non adherence is a major medical problem globally. There are many inter related reasons for the same. Though patient education is the key to improving compliance, use of compliance aids, proper motivation and support is also shown to increase medication adherence. Health care professionals should identify practically possible strategies to improve medication adherence within the limits of their practice eventually enhancing therapeutic outcome. It should be a multidisciplinary approach that needs to be carried out with the support of all those who are involved in medication use.