The document discusses medication adherence and strategies to improve it. It defines medication adherence as a patient's medication-taking behavior. Non-adherence can be intentional, unintentional, or due to socioeconomic factors. Accurately monitoring adherence is difficult due to limitations of methods like medication event tracking systems. Pharmacists can play an important role in improving adherence through counseling, disease management, and enhancing communication with patients and prescribers.

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

2. Introduction:
❑ It is simply defined as ‘Patient’s medication taking behavior’.
❑ Patient participation in treatment as a shared decision-making process. The
patient is under no compulsion to accept a particular treatment.
AGRA PUBLIC PHARMACY COLLEGE,
ARTONI, AGRA, UP, INDIA
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“Drugs don't
work in patients
who don't take
them”

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ARTONI, AGRA, UP, INDIA
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ARTONI, AGRA, UP, INDIA
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CONSEQUENCES
OF NON-
ADHERENCE

5. Cause’s of Non-Adherence:
➢ Patient’s medication non-adherence in many different situations; these have
been categorized based on use , underused & overused for prescription & non-
prescription medications.
AGRA PUBLIC PHARMACY COLLEGE,
ARTONI, AGRA, UP, INDIA
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Source*-https%3A%2F%2Frxoutcomesadviser.wordpress.com/Fcategory/Fmedication-compliance

6. Primary Cause:- Not having a prescription dispensed.
Secondary cause’s:-
1. Intentional:-
• The patient not obey the prescription due to its his own volition.
• Decision is made by the patient to not use treatment or follow treatment
recommendations.
• Ex- patient take less than the prescribed dose with an assumption that the
prescribed dose is high or may take more than the prescribed dose excepting
quicker recovery from the disease.
AGRA PUBLIC PHARMACY COLLEGE,
ARTONI, AGRA, UP, INDIA
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Source*-https%3A%2F%2Ftoday.mims.com%2Fdigging-deep-is-intentional-non-adherence-
among-patients-a-thing&psig

7. 2. Unintentional:-
• Unplanned behavior and is less strongly associated with beliefs, may be the result of
forgetfulness and not knowing exactly how to use medicines.
• Or when the patient has misunderstood or forgotten the doctor’s directions.
• May be due to memory loss or confusions.
3. Socio- economic related:-
• Lack of family or social support network.
• Lack of health care insurance
• Cultural and lay beliefs about illness and treatment
AGRA PUBLIC PHARMACY COLLEGE,
ARTONI, AGRA, UP, INDIA
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Source*- https%3A%2F%2Fhealthitanalytics.com%2Fnews%2Fcost-is-a-primary-driver-of-medication-non-adherence-
rates&psig

8. Monitoring of Patient Medication Adherence
❑ Monitoring of medicine adherence is the difficult task because comparisons
between different research results cannot be made.
❑ Non-adherence is the results of complex interactions among many factors.
AGRA PUBLIC PHARMACY COLLEGE,
ARTONI, AGRA, UP, INDIA
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Source*-https%3A%2F%2Fmedicomhealth.com%2Funderstanding-non-adherencD

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ARTONI, AGRA, UP, INDIA
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10. Medication Event Tracking System
➢ These are the most accurate method of measuring adherence because they
record the date and time the medication bottle was opened through
microprocessor technology embedded in the cap.
➢ Limitations-
➢ Easily manipulated (patient may remove more than one dose, open more than once)
➢ Very expensive & different devices are needed for each medication.
AGRA PUBLIC PHARMACY COLLEGE,
ARTONI, AGRA, UP, INDIA
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Source*-www.westrock.com%2Fproducts%2Ffolding-cartons

11. ➢ Indirect- Subjective (self-report questionnaire )-
➢ Patient review
➢ Diary Keeping
➢ Medication Adherence Questionnaire (MAQ)
➢ The Self-Efficacy for Appropriate Medication Use Scale (SEAMS)
➢ Health outcomes measures-
➢ Ex- Blood pressure control
➢ Asthma Severity
➢ Utilization of healthcare service-
➢ Clinic attendance
➢ Appointment making
➢ Appointment keeping
➢ Preventive visits
AGRA PUBLIC PHARMACY COLLEGE,
ARTONI, AGRA, UP, INDIA
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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
✓ Pharmacist can play important role in improving to medicine adherence; because
they actually bonding with patients to drug distribution.
✓ Pharmacists through patient counseling, medication therapy management, disease
management, have important role in patient care.
✓ As social pharmacy links clinical pharmacy, basic sciences and social sciences,
pharmacy practice able to improve patients’ adherence and therapeutic outcomes.
✓ Enhancing pharmacist-prescriber and pharmacist-patient communication can lead
to significant breakthroughs in adherence.
✓ Some of studies proof that the improvement of adherence by pharmacist education
to the patient.
AGRA PUBLIC PHARMACY COLLEGE,
ARTONI, AGRA, UP, INDIA
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Source*- https%3A%2F%2Flink.springer.com%2Fchapter%2F10.1007%2F978-3-319-76593-8_19&psig

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Strategies to improve the Pharmacist-patient relationship