Medication adherence

Drug Adherence toward to patient

1. MEDICATION ADHERENCE
By:-Dr. Manish Pal Singh,
Associate Professor
1
AGRA PUBLIC PHARMACY COLLEGE,
ARTONI, AGRA, UP, INDIA

2. Introduction:
❑Itissimplydefinedas‘Patient’smedicationtakingbehavior’.
❑Patientparticipationintreatmentasashareddecision-makingprocess.The
patientisundernocompulsiontoacceptaparticulartreatment.
AGRA PUBLIC PHARMACY COLLEGE,
ARTONI, AGRA, UP, INDIA
2
“Drugs don't
work in patients
who don't take
them”

3. AGRA PUBLIC PHARMACY COLLEGE,
ARTONI, AGRA, UP, INDIA
3

4. AGRA PUBLIC PHARMACY COLLEGE,
ARTONI, AGRA, UP, INDIA
4
CONSEQUENCES
OF NON-
ADHERENCE

5. Cause’s of Non-Adherence:
➢Patient’smedicationnon-adherenceinmanydifferentsituations;thesehave
beencategorizedbasedonuse,underused&overusedforprescription&non-
prescriptionmedications.
AGRA PUBLIC PHARMACY COLLEGE,
ARTONI, AGRA, UP, INDIA
5
Source*
-
https%3A%2F%2Frxoutcomesadviser.wordpress.com/
Fcategory
/
Fmedication
-
compliance

6. PrimaryCause:-Nothavingaprescriptiondispensed.
Secondarycause’s:-
1.Intentional:-
•Thepatientnotobeytheprescriptionduetoitshisownvolition.
•Decisionismadebythepatienttonotusetreatmentorfollowtreatment
recommendations.
•Ex-patienttakelessthantheprescribeddosewithanassumptionthatthe
prescribeddoseishighormaytakemorethantheprescribeddoseexcepting
quickerrecoveryfromthedisease.
AGRA PUBLIC PHARMACY COLLEGE,
ARTONI, AGRA, UP, INDIA
6
Source*-https%3A%2F%2Ftoday.mims.com%2Fdigging-deep-is-intentional-non-adherence-
among-patients-a-thing&psig

7. 2.Unintentional:-
•Unplannedbehaviorandislessstronglyassociatedwithbeliefs,maybetheresultof
forgetfulnessandnotknowingexactlyhowtousemedicines.
•Orwhenthepatienthasmisunderstoodorforgottenthedoctor’sdirections.
•Maybeduetomemorylossorconfusions.
3.Socio-economicrelated:-
•Lackoffamilyorsocialsupportnetwork.
•Lackofhealthcareinsurance
•Culturalandlaybeliefsaboutillnessandtreatment
AGRA PUBLIC PHARMACY COLLEGE,
ARTONI, AGRA, UP, INDIA
7
Source*- https%3A%2F%2Fhealthitanalytics.com%2Fnews%2Fcost-is-a-primary-driver-of-medication-non-adherence-
rates&psig

8. Monitoring of Patient Medication Adherence
❑Monitoringofmedicineadherenceisthedifficulttaskbecausecomparisons
betweendifferentresearchresultscannotbemade.
❑Non-adherenceistheresultsofcomplexinteractionsamongmanyfactors.
AGRA PUBLIC PHARMACY COLLEGE,
ARTONI, AGRA, UP, INDIA
8
Source*
-
https%3A%2F%2Fmedicomhealth.com%2Funderstanding
-
non
-
adherencD

9. AGRA PUBLIC PHARMACY COLLEGE,
ARTONI, AGRA, UP, INDIA
9

10. Medication Event Tracking System
➢Thesearethemostaccuratemethodofmeasuringadherencebecausethey
recordthedateandtimethemedicationbottlewasopenedthrough
microprocessortechnologyembeddedinthecap.
➢Limitations-
➢Easilymanipulated(patientmayremovemorethanonedose,openmorethanonce)
➢Veryexpensive&differentdevicesareneededforeachmedication.
AGRA PUBLIC PHARMACY COLLEGE,
ARTONI, AGRA, UP, INDIA
10
Source*
-
www.westrock.com%2Fproducts%2Ffolding
-
cartons

11. ➢Indirect-Subjective(self-reportquestionnaire)-
➢Patientreview
➢DiaryKeeping
➢MedicationAdherenceQuestionnaire(MAQ)
➢TheSelf-EfficacyforAppropriateMedicationUseScale(SEAMS)
➢Healthoutcomesmeasures-
➢Ex-Bloodpressurecontrol
➢AsthmaSeverity
➢Utilizationofhealthcareservice-
➢Clinicattendance
➢Appointmentmaking
➢Appointmentkeeping
➢Preventivevisits
AGRA PUBLIC PHARMACY COLLEGE,
ARTONI, AGRA, UP, INDIA
11
Source*-https%3A%2F%2Fwww.scnsoft.com%2Fblog%2Frfid-and-iot-in-a-smart-hospital-benefits-and-challenges-of-smart-patient-tracking&psig

12. Role of Pharmacist
✓Pharmacistcanplayimportantroleinimprovingtomedicineadherence;because
theyactuallybondingwithpatientstodrugdistribution.
✓Pharmaciststhroughpatientcounseling,medicationtherapymanagement,disease
management,haveimportantroleinpatientcare.
✓Associalpharmacylinksclinicalpharmacy,basicsciencesandsocialsciences,
pharmacypracticeabletoimprovepatients’adherenceandtherapeuticoutcomes.
✓Enhancingpharmacist-prescriberandpharmacist-patientcommunicationcanlead
tosignificantbreakthroughsinadherence.
✓Someofstudiesproofthattheimprovementofadherencebypharmacisteducation
tothepatient.
AGRA PUBLIC PHARMACY COLLEGE,
ARTONI, AGRA, UP, INDIA
12

13. AGRA PUBLIC PHARMACY COLLEGE,
ARTONI, AGRA, UP, INDIA
13
Source*-https%3A%2F%2Flink.springer.com%2Fchapter%2F10.1007%2F978-3-319-76593-8_19&psig

14. AGRA PUBLIC PHARMACY COLLEGE,
ARTONI, AGRA, UP, INDIA
14

15. AGRA PUBLIC PHARMACY COLLEGE,
ARTONI, AGRA, UP, INDIA
15
Strategies to improve the Pharmacist-patient relationship