Patient medication adherence, Medication adherence, Causes of medication non-adherence, Problems linked with Medication Non-adherence, Factors affecting medication adherence, Patient related factors, Social and Economic factor, Disease related factor, Health care provider related factors, Therapy related factors, pharmacist role in the medication adherence, role of pharmacist in the medication adherence, monitoring of patient medication adherence, Direct method, Indirect method

1. Medication adherence
By
Mr. Krushna Kashinathrao Zambare
HOD, Pharmacology
SBSPM B. Pharmacy College, Ambajogai

2. DEFINITION
 The extent to which patients take medications as
prescribed by physician.
OR
 The extent to which patient correctly follows medical
advice.
OR
 As per WHO "the degree to which the person's behavior
corresponds with the agreed recommendations from a
health care provider."
Prof.K.K.Zambare

3. CAUSES OF MEDICATION NON-ADHERENCE
 Intentionally non-adherence to medication
 Intentionally the patient deviates from the treatment
regimen
 Unintentional non-adherence to medication
 Due to carelessness
 Due to Forgetfulness
 High cost of medicine
 Late repurchase of medicines
Prof.K.K.Zambare

4. PROBLEMS LINKED WITH MEDICATION NON-
ADHERENCE
 Therapeutic failure
 Increased exposure to toxicological effects of drugs
 Recurrence of disease
 Unable to cure disease and disease progression
 Leads to complications of disease
 Economic lost to patient
 Low quality of life
 Patients death
Prof.K.K.Zambare

5. FACTORS AFFECTING MEDICATION ADHERENCE
Patient related factors
 Income
 Literacy
 Age of patient
 Gender
 Knowledge of disease
 Severity of disease
 Marital status
 Attitude for treatment
 Efficiency of therapy
 Therapeutic Regimen
 Anxiety
 Anger
 ADR
 Disability
 Unable to swallow
 Stress
 Fear of ADR/ Dependence
Prof.K.K.Zambare

6. FACTORS AFFECTING MEDICATION ADHERENCE
SOCIAL AND ECONOMIC FACTOR
o Busy schedule
o Less access to health
facility
o Low access to
Pharmacy
o Less health literacy
o Lack of family and
social support
o Cultural belief about
disease
Prof.K.K.Zambare

7. FACTORS AFFECTING MEDICATION ADHERENCE
Disease related factor
o Less symptoms of severity
o No symptom or disappearance of symptom
o Psychological diseases
Prof.K.K.Zambare

8. FACTORS AFFECTING MEDICATION ADHERENCE
 Relationship with
provider
 Poor communication
 Poor understanding
 Busy schedule
 Waiting period
o Lack of continuous care
o Lack of Knowledge
o Missing appointments
Health care provider related factors
Prof.K.K.Zambare

9. FACTORS AFFECTING MEDICATION ADHERENCE
Therapy related factors
 Number of doses
 Duration of therapy
 Frequent changes in drugs
 Lack of Immediate relief
 ADR/Side effect
Prof.K.K.Zambare

10. PHARMACIST ROLE IN THE MEDICATION ADHERENCE
o Communication should be good with any patient
o Help the patient education
o Talk friendly to patients
o Always remain approachable to patients
o Ease the patients to talk about their disease
without hesitation
Prof.K.K.Zambare

11. PHARMACIST ROLE IN THE MEDICATION ADHERENCE
o Create awareness about the disease to patients
o Listen carefully the problem of patients
o Explain properly disease condition
o Explain the therapeutic regimen
o Keep an eye on ADR and Side effects
o Check the understanding of patient
Prof.K.K.Zambare

12. PHARMACIST ROLE IN THE MEDICATION ADHERENCE
o Monitor effectiveness of therapy
o Always communicate in same language
o Take account of psychological state and
spiritual need of patient
o Good communication between Pharmacist -
Physician and Pharmacist-Patient
Prof.K.K.Zambare

13. MONITORING OF PATIENT MEDICATION ADHERENCE
 Direct method
 Directly observe the treatment
 Measure the concentration of drug in blood or
metabolite in urine
Drawback
 Expensive
 Patient hide drug in mouth
 Altered metabolism
Prof.K.K.Zambare

14. MONITORING OF PATIENT MEDICATION ADHERENCE
 Indirect method
 Count the medicine
(Tablet/Capsule)
 Questionnaires for patients
 Refill rates of Prescription
 Measure Pharmacological
response
 Electronic medication
monitor
Drawbacks
 Expensive
 Patient may lie
 Response may be
change due to various
factors
Prof.K.K.Zambare

15. MONITORING OF PATIENT MEDICATION ADHERENCE
 Medication event Monitoring system
 Easy method
 It records date and time of medication intake
 Bottles are fitted with microprocessor embedded
technology in cap
Drawback
 Patient may manipulate the regimen (Open bottle so
many times, may take excess dose)
 Expensive
 Inaccurate
Prof.K.K.Zambare