MEDICATION ADHERENCE.pptx

MEDICATION ADHERENCE.pptx

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  B.PHARM VIIth SEMESTER PHARMACYPRACTICE (Theory) Subject code- BP 703T UNIT-II ANIL DHAKAL
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  D. MEDICATION ADHERENCE •Medication adherence is the one of the most important factors that determines the therapeutic out comes, especially in a patient suffering from chronic diseases. • Whatever the efficiency of the drug, it can’t act unless the patient takes it positively. • Adherence to treatment is the key link between treatment and outcome in medical care. • Medication adherence demands a working relationship between a patient or caregiver and prescriber that values open, honest discussion about medications, i.e. the administration schedule, intended benefits, adverse effects and costs.
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  1. CAUSES OFMEDICATION NON- ADHERENCE • Non-adherence with medication is a complex and multidimensional health care problem. • The causes may be related to the patient, treatment, and/or health care provider. The patients may not believe the treatment is necessary complex treatment plans may increase the risk of nonadherence and there may be insufficient communication between patient and provider [11]. As a consequence of nonadherence, substantial numbers of patients do not benefit optimally from medication, resulting in increased morbidity and mortality as well as increased societal costs [12]. • The elderly are a patient group that is vulnerable to negative health outcomes due to lack of adherence. Because older patients often use a variety of drugs for a number of chronic diseases, the consequences of nonadherence may be more serious, but nonadherence may be less easily detected and resolved than in younger age groups. • Factors that may predict nonadherence include forgetfulness, illiteracy, inability to understand the purpose of treatment, not perceiving the treatment as necessary, a lack of trust in the treatment, and a lack of knowledge about the effects of treatment. In addition, psychiatric problems, including depression, cognitive limitations, missing visits, and a poor relationship with the health care provider have also been found to contribute to nonadherence. Some of these factors are associated with intentional nonadherence, while others are more likely to be correlated with unintentional nonadherence [13].
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  The number ofco-morbid conditions and presence of cognitive, vision and/or hearing impairment may predispose the patient to nonadherence. Similarly, medications themselves may contribute to nonadherence secondary to adverse effects or costs. Especially worrisome is nonadherence to ‘less forgiving’ drugs that, when missed may lead to an adverse event (e.g. withdrawal symptoms) or disease exacerbation. Non-adherence was associated with higher health care costs for both in- and outpatient settings. Patients need educated regarding non-adherence and increased costs. Non-adherence also incurred more costs for outpatient services and office visits. Several interventions may contribute to improved adherence
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  2. ROLE OFPHARMACIST 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 means—can play a pivotal role in patient care. There are opportunities in every type of pharmacy practice to improve patients’ adherence and therapeutic outcomes, and pharmacists must embrace and act on them. Patient Education, dosing simplification and minimization of adverse effects are extremely successful strategies for improving adherence. Preparing a dosing card containing only the most essential elements of the patient’s medications can be highly beneficial. It can be extremely helpful for patients who take many medications or who have cognitive barriers. Reminder calls, texts, or e-mails are helpful for many patients, especially those with busy lifestyles. Automatic refills are a useful strategy Whatever the barriers to adherence may be, the only way to assess them is to talk to the patient
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  The pharmacist needsto be diligent (pay attention) about including the patient in the treatment experience. The more trust the patient has in the pharmacist, the more he or she will open up and disclose any apprehensions or difficulties about taking his or her medication. Only then can the pharmacist play an integral role in improving a patient’s adherence. Pharmacists are in unique position to improve medication adherence because they can actually show the medication to the patient and relate any information to the medication itself. Apart from patient education, a pharmacist may contribute towards improving medication adherence by other means including advice to prescribers on the simplification of drug regimens, providing patients with medication cards or medication aids such as a dosette, and by identifying the predisposing, enabling, and reinforcing factors which may contribute towards medication non-adherence. Though patient interviews, the pharmacists can assess the patient’s knowledge of their drug therapy and usual medication habit
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  3. MONITORING OFPATIENT MEDICATION ADHERENCE • Medication non-adherence is a prevalent, complex problem. Failure to follow medication schedules may lead to major health complications, including death. Proper medication adherence is thus required in order to gain the greatest possible drug benefit during a patient’s treatment. Interventions have been proven to improve medication adherence if deviations are detected. • Full adherence to medication is required as the drug can be effective only when it is taken . Nonetheless, maintaining strict medication adherence is required that deems maintaining administration timing, dosage quantity, and frequency. • A wealth of reports revealed that up to 50% of the patients either never fill their medication prescriptions or do not use the medication as prescribed to them in medication regimens. Unfortunately, poor adherence is prevalent among populations with chronic illnesses, which leads to hospital admission. • A number of approaches have been used for the aim of monitoring medication adherence because it has been shown that improving adherence to medical therapy would substantially lead to both health and economic benefits.
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  • In general,two key factors should be considered when discussing medication adherence. The first factor is monitoring, which is alternatively referred to as assessment, quantification, measurement, or evaluation. Medication monitoring means using some methods for observing if the patient has taken the medication or not. Hence, the effectiveness of the monitoring method plays a central role. • The second factor is intervention. Interventions refer to the means that can be used for improving adherence to medication or correcting it once erroneous or drift is detected. Methods that have been utilized for measuring medication adherence so far can be broadly divided into two categories, direct and indirect. Direct methods of measurement of adherence include direct observation of the patient while taking the medication, laboratory detection of the drug in the biologic fluid of the patient (i.e., blood or urine), laboratory detection of the presence of nontoxic markers added to the medication in the biologic fluid of the patient, and laboratory detection of the presence of biomarkers in the dried blood spots. Meanwhile, the patient’s self reporting, pill-counting, assessing pharmacy refill rates, and using electronic medication event tracking systems are examples of indirect methods of measuring adherence. • Direct measures are accurate, but they may require invasiveness, 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
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