Medication Adherence
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Presentation detailing the basics and boundaries of medication adherence.

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 Presentation Transcript

  • 1. MEDICATION ADHERENCE: DEFINING THE PROBLEMNovember 7, 2012Marquila Ferrell & Sarah HudsonThe University of Toledo
  • 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. 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. 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. 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. 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. Effects of Medication Non-Adherence7  Increased hospital readmission  Increased disease progression and complications  Increased health care costs  Decreased quality of life  Patient death
  • 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. 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. 5 Dimensions of Medication Adherence10 Adult Meducation (2006). Overview of Medication Adherence. American Society on Aging and American Society of Consultant Pharmacists Foundation.
  • 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. 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. 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. 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. Questions15
  • 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/.