This document discusses medication adherence and factors that influence a patient's compliance. It defines medication adherence as a patient following their provider's recommendations on timing, dosage, and frequency of medication. Non-adherence can be caused by socioeconomic factors, healthcare system issues, therapy complexity, a patient's condition, or individual patient factors. The document outlines the pharmacist's role in educating patients and monitoring adherence through direct methods like drug testing or indirect methods like patient surveys. Pharmacists can improve adherence by simplifying regimens, addressing side effects, and enhancing patient-provider communication.

1. MEDICATION ADHERENCE
Dr. Subhash R. Yende
Asst. Professor,
Gurunanak College of Pharmacy, Nagpur
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2. INTRODUCTION
Medication Adherence:
 The patient’s conformance with the provider’s
recommendation with respect to timing, dosage and
frequency of medication-taking during the prescribed
length of time.
 It is a factors that determines the therapeutic out comes,
in a patient suffering from chronic illness/diseases.
Compliance:
How well the patient follows the instruction of when and
how to take the medication
Persistence:
Duration of time patient takes medication, from initiation
to discontinuation of therapy 2

3. CAUSES OF MEDICATION NON-ADHERENCE
 Socio-economic
 Poor socioeconomic status, illiteracy, unemployment
 Lack of family or social support
 lack of financial resources
 Busy work schedules
 High cost of medication
 Health care system related
 Relationship of doctor-patient
 Poor or lack of proper communication regarding the
beneficial effect of taking medication, instructions for
use and side effects
 Poor medication distribution
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4.  Therapy related
 Complexity of medical regimens,
duration of treatments
 Lack of immediate benefit of therapy and treatment
interferes with lifestyle
 Condition related
 Severity of symptoms (chronic illness requires long
term drugs administration OR few or no symptoms)
 Patient related
 Impairments such as visual, hearing and cognitive
impairments and swallowing problems
 Lack of motivation, apprehension about possible
adverse side effects
 Stress, anxiety 4

5. PHARMACISTS ROLE IN MEDICATION ADHERENCE
 Pharmacists can improve medication
adherence because they can actually show
the medication to the patient and relate any information
to the medication itself.
 Educate patients regarding medication adherence
 Pharmacists can impart the information that patients
need to know such as-
 Name and purpose of the drug,
 When and how to take the medication,
 Possible side effects, Precautions, Interaction with
food or other drugs,
 Duration of therapy,
 Action to take if a dose is missed etc.
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6.  A pharmacist can advice to prescribers on the
simplification of drug regimens and reinforcing factors
which may contribute towards medication non-
adherence.
 A pharmacists can assess the
patient’s knowledge of their
drug therapy and usual medication
habits
 The pharmacists can also assess the patient’s ability to
comprehend and recall information, and if an adverse
drug reaction may discourage medication adherence. 6

7. Strategies to improve the pharmacist-patient
relationship:
 Be friendly and approachable to the patient.
 Improve communication skills.
 Take into account the spiritual and psychological needs
of the patient.
 Improving patient education.
 Give clear explanation.
 Check the patient understanding.
 Simplify the therapeutic regimes.
 Monitor the side effects.
 Monitor the beneficial effects.
 Speak the same language of patient.
 Involvement of patient treatment discussion.
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8. MONITORING OF MEDICATION ADHERENCE
 Assessment, quantification,
measurement and evaluation
of adherence
 Direct and Indirect methods
 The direct measurement includes –
 drug monitoring
 detection of the drug or its metabolites in biological
fluid
 direct observation therapy
 Most accurate methods of adherence measurement
but are expensive 8

9.  The Indirect measurement includes –
 self reports,
 pill counts,
 rates of prescription refills,
 assessment of the patient’s clinical response
 measurement of physiologic markers as well as
patient diaries
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10. Direct Measurement:-
 Home finger prick sampling
 Biological markers
 Directly observed therapy
Indirect Measurements:-
 Self-report measures (using questionnaires)
 Morisky’s medication adherence scale
 Medical outcome adherence study scale
 Brief Adherence Rating Scale
 Electronic Adherence monitoring
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11. Reference
 https://www.slideshare.net/rameshganpisetti/medication-
adherence-93414237
 Dwajani S., Prabhu MR, Ranjana G., Sahajananda H.
Importance of medication adherence and factors
affecting it. International Journal of Compressive and
advanced pharmacology, 2018, 3 (2), 69-77.
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