MEDICATION ADHERENCE:     DEFINING THE PROBLEMNovember 7, 2012Marquila Ferrell & Sarah HudsonThe University of Toledo
Objectives2       Define medication adherence       Explore the differences between medication        adherence and medi...
Introduction3       125,000 people die a year due to failure to take        medication or taking medications improperly  ...
What is Medication Adherence?4        “The extent to which patients take     medications as prescribed by health care     ...
Medication Adherence vs. Patient Compliance5      “Compliance suggests that the patient is passively     following the doc...
Medication Non-Adherence6       Intentional medication non-adherence          “Active process whereby the patient choose...
Effects of Medication Non-Adherence7       Increased hospital readmission       Increased disease progression and compli...
Patient Interviews8      “Taking my medication helps balance my      life. If I do not take it, I often get sick or       ...
Why Don’t Patients Take Their Medicine?9                         Most Common Reported Reasons         Late Refill         ...
5 Dimensions of Medication Adherence10     Adult Meducation (2006). Overview of Medication Adherence. American Society on ...
Clinical Case Study11        Primary source          48   year old African American male with low            socioeconom...
Post-Discharge Report12     Measures                            Details                               Results     Barriers...
Study Results13        Limitations to medication adherence for Mr. P          Low  socioeconomic status          Lived ...
Summary14        What medication adherence is        Significance of adhering to medications        Barriers to proper ...
Questions15
Resources16        Adult Meducation. (2006). Overview of Medication Adherence. American Society on                Aging a...
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Medication Adherence

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Presentation detailing the basics and boundaries of medication adherence.

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  • Patient stated he could afford his medications and foresaw no difficulties in obtaining and filling medications.Morisky scale-POOR ADHERENCEElectronic pill bottle-POOR ADHERENCE
  • Medication Adherence

    1. 1. MEDICATION ADHERENCE: DEFINING THE PROBLEMNovember 7, 2012Marquila Ferrell & Sarah HudsonThe University of Toledo
    2. 2. Objectives2  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?
    3. 3. Introduction3  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 Script Your Future. (2012). National Consumers League.
    4. 4. What is Medication Adherence?4 “The extent to which patients take medications as prescribed by health care providers.” Osterberg, L., & Blaschke, T. (2005). Adherence to medication. New England journal of medicine, 353(5), 487- 97.
    5. 5. Medication Adherence vs. Patient Compliance5 “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.” Osterberg, L., & Blaschke, T. (2005). Adherence to medication. New England journal of medicine, 353(5), 487.
    6. 6. Medication Non-Adherence6  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.” Ho, P., Bryson, C., , & Rumsfeld, J. (2009). Medication adherence: Its importance in Cardiovascular Outcomes. Circulation, 119(23), 3031.
    7. 7. Effects of Medication Non-Adherence7  Increased hospital readmission  Increased disease progression and complications  Increased health care costs  Decreased quality of life  Patient death
    8. 8. Patient Interviews8 “Taking my medication helps balance my life. If I do not take it, I often get sick or have emotional episodes.”
    9. 9. Why Don’t Patients Take Their Medicine?9 Most Common Reported Reasons Late Refill 10% Clinical Questions 15% Missed Dose 39% High Cost 16% Late Renewal 20% Express Scripts (2012). Retrieved from http://lab.express-scripts.com/wp- content/uploads/2012/07/Americas_317B_Condition.pdf
    10. 10. 5 Dimensions of Medication Adherence10 Adult Meducation (2006). Overview of Medication Adherence. American Society on Aging and American Society of Consultant Pharmacists Foundation.
    11. 11. Clinical Case Study11  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 Ye, Siqin, Krupka, David, & Davidson, Karina. (2012). Diagnosing medication non-adherence in a patient with myocardial infarction. Frontiers In Psychology, 3:267, 1-3.
    12. 12. Post-Discharge Report12 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, self- 7/7 for all medications 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 Ye, Siqin, Krupka, David, & Davidson, Karina. (2012). Diagnosing medication non-adherence in a patient with myocardial infarction. Frontiers In Psychology, 3:267, 7.
    13. 13. Study Results13  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 Ye, Siqin, Krupka, David, & Davidson, Karina. (2012). Diagnosing medication non-adherence in a patient with myocardial infarction. Frontiers In Psychology, 3:267, 4.
    14. 14. Summary14  What medication adherence is  Significance of adhering to medications  Barriers to proper medication adherence  Pharmacists and MTM services  Health outcomes and pharmacy administrators
    15. 15. Questions15
    16. 16. Resources16  Adult Meducation. (2006). Overview of Medication Adherence. American Society on Aging and American Society of Consultant Pharmacists Foundation. Retrieved from http://www.adultmeducation.com/OverviewofMedicationAdherence_4.html.  Express Scripts (2012). Retrieved from http://lab.express-scripts.com/wp-content/uploads/ 2012/07/Americas_317B_Condition.pdf  Ho, P., Bryson, C., , & Rumsfeld, J. (2009). Medication adherence: its importance in cardiovascular outcomes. Circulation, 119(23), 3028-35. Retrieved from http:// www.ncbi.nlm.nih.gov/pubmed/19528344.  Osterberg, L., & Blaschke, T. (2005). Adherence to medication. New England journal of medicine, 353(5), 487-97. Retrieved from http://www.nejm.org/doi/full/ 10.1056/NEJMra050100.  Script Your Future. (2012). National Consumers League. Retrieved from http:// scriptyourfuture.org/medication-adherence/.  Ye, Siqin, Krupka, David, & Davidson, Karina. (2012). Diagnosing medication non- adherence in a patient with myocardial infarction. Frontiers In Psychology, 3:267, 1-7. Retrieved from http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3411184/.
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