This document discusses strategies to improve medication adherence. It defines medication adherence and factors that influence adherence such as social/economic barriers, therapy complexity, and patient beliefs. Methods to measure adherence include direct testing and indirect methods like patient surveys. Strategies to improve adherence involve simplifying prescriptions, educating patients, addressing barriers, and using technology like smart packaging and mobile apps. The document emphasizes the importance of physician-patient collaboration to improve education and empowerment.
Medication adherence is essential for achieving positive therapeutic outcomes, especially in chronic diseases. Non-adherence has many causes like patients not believing treatment is necessary, complex regimens, or poor communication with providers. Pharmacists can play an important role in improving adherence through patient education, simplifying dosing, minimizing side effects, reminder calls/texts, and identifying individual barriers. Proper adherence monitoring is also important, as it allows interventions when non-adherence is detected. Both direct methods like biological fluid testing and indirect methods like pill counting can assess adherence, though indirect methods are less expensive.
Introduction: Medication adherence is defined by the World Health Organisation as “The degree to which the person's behaviour corresponds with the agreed recommendations from a health care provider
Factor Affecting Non-Adherance:Poor adherence or non-adherence to medical treatment severely compromises patient outcomes and increases patient mortality.
Non-adherence is a very common phenomenon in all patients with drug-taking behaviour.
The complexity of adherence is the result of an interplay of a range of factors, including patient views and attributes, illness characteristics, social contexts, access, and service issues.
Non-adherence: Non-adherence is the failure or refusal to comply with advice and can imply disobedience on the part of patient
5 step Factors: Social/economic and Economic Factors
Provider-patient/health care system factors
Condition-related factors
Therapy-related factors
Patient-related factors
Behavioural Factors:
Life style (smoking, alcohol, coffee use) Psychological and personality factors: anxiety, depression, coping style
Biological factors:
Gender, age, and genetic predisposition
Social and cultural factors:
Educational level, living situation, price of medication, policies.
Information Factors:
Have you received enough information? Satisfaction with the last visit?
Awareness factors:
Severity of the complaints (Baseline) quality of life,
Locus of control about patient adherence:
internal and external, stability and control about the cause of the complaints: internal and external, stability and controllability.
Stages to Overcome This Barrier
This document discusses strategies to improve patient medication adherence. It begins by defining medication adherence as a patient taking medications as prescribed in terms of dosage, time, frequency, and directions. Some key factors that influence non-adherence are identified as the high cost of medicines, a lack of understanding about medication regimens, side effect scares, and difficulties refilling prescriptions. The document then outlines several strategies to overcome non-adherence, including simplifying regimens, improving communication with patients, educating patients about their conditions and treatments, and monitoring adherence.
Medication Safety- Administration and monitoring.pptxLatha Venkatesan
The document discusses medication safety and reducing medication errors. It covers several key points:
1) Medication errors are common, especially during transitions of care between settings. The WHO aims to reduce medication-related harm by 50% through their "Medication Without Harm" challenge.
2) Medication errors can occur at various stages like prescribing, transcribing, dispensing, and administering. High-risk medications and situations like polypharmacy also increase error risk.
3) Strategies to improve safety include training, protocols, technology like CPOE, reconciliation, and empowering patients. A multidisciplinary team approach is important to strengthen systems and practices.
This document discusses drug therapy monitoring and pharmaceutical care. It outlines the key components and goals of drug therapy monitoring including medication order review, clinical review, and pharmacist intervention. The goals are to optimize drug therapy, prevent medication errors, and assess therapeutic outcomes. It also discusses the process of pharmaceutical care which involves identifying drug-related problems, determining treatment goals, developing and implementing care plans, and monitoring outcomes. The overall aim is to provide responsible drug therapy to improve patients' quality of life.
This document discusses several aspects of patient care including patient-centered care, inpatient care, services provided by an inpatient care department, the role of pharmacists in ensuring patient safety and quality care, and programs to promote appropriate medication use such as drug utilization review and prior authorization. It also describes how managed care pharmacists work to develop clinical programs, facilitate communication between patients and providers, design effective health benefit structures, and contract with various organizations to structure business arrangements that meet population needs.
Medication adherence is essential for achieving positive therapeutic outcomes, especially in chronic diseases. Non-adherence has many causes like patients not believing treatment is necessary, complex regimens, or poor communication with providers. Pharmacists can play an important role in improving adherence through patient education, simplifying dosing, minimizing side effects, reminder calls/texts, and identifying individual barriers. Proper adherence monitoring is also important, as it allows interventions when non-adherence is detected. Both direct methods like biological fluid testing and indirect methods like pill counting can assess adherence, though indirect methods are less expensive.
Introduction: Medication adherence is defined by the World Health Organisation as “The degree to which the person's behaviour corresponds with the agreed recommendations from a health care provider
Factor Affecting Non-Adherance:Poor adherence or non-adherence to medical treatment severely compromises patient outcomes and increases patient mortality.
Non-adherence is a very common phenomenon in all patients with drug-taking behaviour.
The complexity of adherence is the result of an interplay of a range of factors, including patient views and attributes, illness characteristics, social contexts, access, and service issues.
Non-adherence: Non-adherence is the failure or refusal to comply with advice and can imply disobedience on the part of patient
5 step Factors: Social/economic and Economic Factors
Provider-patient/health care system factors
Condition-related factors
Therapy-related factors
Patient-related factors
Behavioural Factors:
Life style (smoking, alcohol, coffee use) Psychological and personality factors: anxiety, depression, coping style
Biological factors:
Gender, age, and genetic predisposition
Social and cultural factors:
Educational level, living situation, price of medication, policies.
Information Factors:
Have you received enough information? Satisfaction with the last visit?
Awareness factors:
Severity of the complaints (Baseline) quality of life,
Locus of control about patient adherence:
internal and external, stability and control about the cause of the complaints: internal and external, stability and controllability.
Stages to Overcome This Barrier
This document discusses strategies to improve patient medication adherence. It begins by defining medication adherence as a patient taking medications as prescribed in terms of dosage, time, frequency, and directions. Some key factors that influence non-adherence are identified as the high cost of medicines, a lack of understanding about medication regimens, side effect scares, and difficulties refilling prescriptions. The document then outlines several strategies to overcome non-adherence, including simplifying regimens, improving communication with patients, educating patients about their conditions and treatments, and monitoring adherence.
Medication Safety- Administration and monitoring.pptxLatha Venkatesan
The document discusses medication safety and reducing medication errors. It covers several key points:
1) Medication errors are common, especially during transitions of care between settings. The WHO aims to reduce medication-related harm by 50% through their "Medication Without Harm" challenge.
2) Medication errors can occur at various stages like prescribing, transcribing, dispensing, and administering. High-risk medications and situations like polypharmacy also increase error risk.
3) Strategies to improve safety include training, protocols, technology like CPOE, reconciliation, and empowering patients. A multidisciplinary team approach is important to strengthen systems and practices.
This document discusses drug therapy monitoring and pharmaceutical care. It outlines the key components and goals of drug therapy monitoring including medication order review, clinical review, and pharmacist intervention. The goals are to optimize drug therapy, prevent medication errors, and assess therapeutic outcomes. It also discusses the process of pharmaceutical care which involves identifying drug-related problems, determining treatment goals, developing and implementing care plans, and monitoring outcomes. The overall aim is to provide responsible drug therapy to improve patients' quality of life.
This document discusses several aspects of patient care including patient-centered care, inpatient care, services provided by an inpatient care department, the role of pharmacists in ensuring patient safety and quality care, and programs to promote appropriate medication use such as drug utilization review and prior authorization. It also describes how managed care pharmacists work to develop clinical programs, facilitate communication between patients and providers, design effective health benefit structures, and contract with various organizations to structure business arrangements that meet population needs.
Pharmaceutical care involves designing and managing drug therapy plans to improve patients' quality of life. The goal is to optimize health outcomes while minimizing costs. Key aspects of pharmaceutical care include identifying and resolving drug-related problems, developing personalized treatment plans, educating patients, and monitoring progress. However, lack of elements like effective communication could lead to unintended situations, as seen in a study where 40% of parents gave young children cough medicine despite labels warning against its use in that age group.
Medical noncompliance, or a patient not following a doctor's prescribed treatment, is common. Half of newly diagnosed patients stop taking medication within 10 days, often because of costs, difficult regimens, or apathy. Doctors must provide detailed information on diagnoses, treatments, and costs to help patients make informed decisions. Both doctors and patients asking each other questions can help ensure patients understand how treatments may impact their lives. Strategies like pill boxes and phone reminders can help patients adhere to medication schedules. Open communication and trust between doctors and patients is key to preventing medical noncompliance.
The document discusses rational medication use and patient compliance. It defines rational use as prescribing the appropriate drug, dose, duration and cost to meet a patient's clinical needs. Irrational use can lead to ineffective treatment, prolonged illness and increased costs. The document outlines factors influencing rational use and strategies to improve it, including educational, managerial, economic and regulatory approaches. It also defines adherence versus compliance, discusses causes and measurements of non-compliance, and factors affecting a patient's ability to comply with medication instructions.
brief review on clinical pharmacy, drug information centre & patient safety program
The lecture was presented at Al-Mahmoudiya General Hospital as part of the training course for fresh appointed pharmacist at 16/5/2023 at 11 & 15/5/2023
This document discusses medication adherence. It defines medication adherence and explains that it is one of the most important factors in determining therapeutic outcomes, especially for chronic illnesses. The document outlines different types of medication non-adherence, including primary and secondary (both intentional and unintentional) non-adherence. It also discusses various methods for measuring and improving medication adherence.
Clinical pharmacy is focused on optimizing medication therapy and promoting health. It is more developed in Western countries than in Nepal, where pharmacy education is industry-oriented and hospital pharmacy roles are undefined. Clinical pharmacists perform various patient care activities like taking medication histories, patient education, monitoring drug therapy, formulating policies, providing drug information, research, and adverse drug reaction reporting to optimize outcomes. Pharmaceutical care involves designing and monitoring therapeutic plans between pharmacists and other providers to improve patients' quality of life. Key responsibilities of clinical pharmacists include identifying and resolving medication-related problems.
Patient counselling involves providing patients with information about their medications, including how to take them properly, potential side effects, and monitoring for drug interactions. An effective counselling session establishes trust, actively listens to patient concerns, tailors information to individual needs, and motivates patients to adhere to their medication regimen. The goal is to help patients safely use their medications and better manage their health conditions.
This document discusses medication adherence, including its definition, causes of non-adherence, factors influencing adherence, and methods for monitoring and improving adherence. Medication adherence refers to a patient correctly following medical advice regarding medication. Non-adherence can be due to patient-related factors like beliefs, costs, and forgetfulness or provider-related factors like poor education. Adherence is influenced by predisposing, enabling, and reinforcing factors. Methods for monitoring include direct measures like drug levels or indirect ones like patient surveys and prescription refill rates. Improving adherence involves effective provider-patient communication and education.
This document outlines the scope of practice for pharmacists and models of pharmacy care. It discusses that pharmacists' scope is regulated at the state level and includes interpreting, evaluating, dispensing, and implementing medical orders as well as providing patient care services. Two common models of pharmacy care discussed are pharmaceutical care, which involves optimizing patient health outcomes, and medication therapy management, which ensures best therapeutic outcomes for patients through medication therapy reviews and follow-up.
Clinical pharmacy involves optimizing patient medication use and health outcomes. It includes collecting patient data, identifying drug-related problems, monitoring treatment, and educating patients. Clinical pharmacists play an important role in hospitals and communities by reviewing medication orders, participating in ward rounds, conducting medication reconciliation, and providing pharmaceutical care. Dosage adjustment may be needed in renal or hepatic disease based on a drug's pharmacokinetics and a patient's disease state.
Medication adherence refers to the extent to which a patient follows medical advice regarding prescribed medications. It is important for therapeutic outcomes, especially for chronic illnesses. While many factors can influence adherence, it is difficult to predict. Pharmacists are well-positioned to improve adherence through patient education about their medications, potential side effects, and the importance of adherence. Strategies like simplifying dosing regimens, using medication organizers, and addressing specific barriers can also help. Further research is still needed to better understand and promote adherence.
Medication adherence refers to the extent to which a patient follows medical advice regarding prescribed medications. It is important for therapeutic outcomes, especially for chronic illnesses. While many factors can influence adherence, it is difficult to predict. Pharmacists are well-positioned to improve adherence through patient education about their medications, potential side effects, and the importance of adherence. Strategies like simplifying dosing regimens, using medication organizers, and addressing specific barriers can also help. Further research is still needed to better understand and promote adherence.
Pharmacovigilance involves monitoring the safety of medicines through activities like safety reporting. It aims to detect adverse drug reactions and ensure the safe use of medications. Pharmacovigilance emerged in the 1960s in response to the thalidomide tragedy and involves collaboration between healthcare stakeholders. It focuses on collecting, analyzing, and communicating information on drug safety to regulatory authorities, healthcare providers, and patients.
This document discusses guidelines for rational and appropriate pharmacotherapy in geriatric patients. It notes that older patients are more susceptible to adverse drug effects due to multiple illnesses, physiological changes, and reduced organ function. When prescribing for older adults, doctors should balance potential harms and benefits, regularly review prescriptions, use appropriate formulations, avoid symptomatic prescribing, consider non-prescribed medications, anticipate pharmacological differences in aging bodies, and be aware that adverse drug reactions may present atypically. The guidelines emphasize cautious, individualized prescribing tailored to each older patient's needs and risks.
This document discusses the importance of proper drug administration in nursing practice. It outlines the traditional five rights of drug administration - right client, right drug, right dose, right time, right route - as well as five additional rights including right assessment, right documentation, patient's right to education, right evaluation, and patient's right to refuse. It emphasizes that nurses are accountable for safely administering medications by verifying orders, understanding each drug's effects and interactions, and ensuring patients provide informed consent before treatment.
Drug utilization evaluation(DUE) & Drug utilization review)Pooja Anothra
Drug utilization evaluation (DUE) is a systematic, ongoing evaluation of drug therapy that ensures medications are used appropriately and meet current standards of care. The goals of DUE include promoting optimal medication therapy, creating guidelines for appropriate drug use, and controlling costs. The DUE process involves establishing responsibility, developing review criteria, collecting and analyzing data, providing feedback to prescribers, and conducting follow-up evaluations. Drug utilization review (DUR) similarly involves ongoing review of prescribing, dispensing, and drug use, and can be prospective, concurrent, or retrospective to identify problems and improve medication therapy.
The document provides an overview of clinical pharmacy, including its definition, development, scope, and the functions and responsibilities of clinical pharmacists. It discusses key aspects of clinical pharmacy practice such as medication chart review, clinical review, pharmacist intervention, ward round participation, medication history, and pharmaceutical care. The summary is as follows:
Clinical pharmacy deals with the safe and effective use of drugs in patient care. It aims to optimize medication use and promote health. Clinical pharmacists are involved in medication monitoring, patient education, and ensuring rational drug therapy.
Key responsibilities of clinical pharmacists include collecting patient data, identifying drug-related problems, establishing treatment goals, evaluating and modifying drug regimens, and monitoring treatment outcomes.
This document discusses patient medication adherence. It defines adherence as taking medication as recommended by a healthcare provider. Non-adherence can be unintentional due to complex regimens or intentional if a patient stops medication. The World Health Organization identified 5 dimensions that influence adherence: social/economic factors, healthcare system factors, condition-related factors, therapy-related factors, and patient-related factors. Methods for measuring adherence include medication monitors, patient self-reports, pill counts, pharmacy records, and the Morisky Medication Adherence Scale. Pharmacists can improve adherence through education, simplifying regimens, identifying barriers, and reminding patients.
hOME MEDICATION REVIEW IS out standing self-employment opportunities with good clinical skills and hand on practice for pharm d students..its well an established program in Australia.
Pharmaceutical care involves designing and managing drug therapy plans to improve patients' quality of life. The goal is to optimize health outcomes while minimizing costs. Key aspects of pharmaceutical care include identifying and resolving drug-related problems, developing personalized treatment plans, educating patients, and monitoring progress. However, lack of elements like effective communication could lead to unintended situations, as seen in a study where 40% of parents gave young children cough medicine despite labels warning against its use in that age group.
Medical noncompliance, or a patient not following a doctor's prescribed treatment, is common. Half of newly diagnosed patients stop taking medication within 10 days, often because of costs, difficult regimens, or apathy. Doctors must provide detailed information on diagnoses, treatments, and costs to help patients make informed decisions. Both doctors and patients asking each other questions can help ensure patients understand how treatments may impact their lives. Strategies like pill boxes and phone reminders can help patients adhere to medication schedules. Open communication and trust between doctors and patients is key to preventing medical noncompliance.
The document discusses rational medication use and patient compliance. It defines rational use as prescribing the appropriate drug, dose, duration and cost to meet a patient's clinical needs. Irrational use can lead to ineffective treatment, prolonged illness and increased costs. The document outlines factors influencing rational use and strategies to improve it, including educational, managerial, economic and regulatory approaches. It also defines adherence versus compliance, discusses causes and measurements of non-compliance, and factors affecting a patient's ability to comply with medication instructions.
brief review on clinical pharmacy, drug information centre & patient safety program
The lecture was presented at Al-Mahmoudiya General Hospital as part of the training course for fresh appointed pharmacist at 16/5/2023 at 11 & 15/5/2023
This document discusses medication adherence. It defines medication adherence and explains that it is one of the most important factors in determining therapeutic outcomes, especially for chronic illnesses. The document outlines different types of medication non-adherence, including primary and secondary (both intentional and unintentional) non-adherence. It also discusses various methods for measuring and improving medication adherence.
Clinical pharmacy is focused on optimizing medication therapy and promoting health. It is more developed in Western countries than in Nepal, where pharmacy education is industry-oriented and hospital pharmacy roles are undefined. Clinical pharmacists perform various patient care activities like taking medication histories, patient education, monitoring drug therapy, formulating policies, providing drug information, research, and adverse drug reaction reporting to optimize outcomes. Pharmaceutical care involves designing and monitoring therapeutic plans between pharmacists and other providers to improve patients' quality of life. Key responsibilities of clinical pharmacists include identifying and resolving medication-related problems.
Patient counselling involves providing patients with information about their medications, including how to take them properly, potential side effects, and monitoring for drug interactions. An effective counselling session establishes trust, actively listens to patient concerns, tailors information to individual needs, and motivates patients to adhere to their medication regimen. The goal is to help patients safely use their medications and better manage their health conditions.
This document discusses medication adherence, including its definition, causes of non-adherence, factors influencing adherence, and methods for monitoring and improving adherence. Medication adherence refers to a patient correctly following medical advice regarding medication. Non-adherence can be due to patient-related factors like beliefs, costs, and forgetfulness or provider-related factors like poor education. Adherence is influenced by predisposing, enabling, and reinforcing factors. Methods for monitoring include direct measures like drug levels or indirect ones like patient surveys and prescription refill rates. Improving adherence involves effective provider-patient communication and education.
This document outlines the scope of practice for pharmacists and models of pharmacy care. It discusses that pharmacists' scope is regulated at the state level and includes interpreting, evaluating, dispensing, and implementing medical orders as well as providing patient care services. Two common models of pharmacy care discussed are pharmaceutical care, which involves optimizing patient health outcomes, and medication therapy management, which ensures best therapeutic outcomes for patients through medication therapy reviews and follow-up.
Clinical pharmacy involves optimizing patient medication use and health outcomes. It includes collecting patient data, identifying drug-related problems, monitoring treatment, and educating patients. Clinical pharmacists play an important role in hospitals and communities by reviewing medication orders, participating in ward rounds, conducting medication reconciliation, and providing pharmaceutical care. Dosage adjustment may be needed in renal or hepatic disease based on a drug's pharmacokinetics and a patient's disease state.
Medication adherence refers to the extent to which a patient follows medical advice regarding prescribed medications. It is important for therapeutic outcomes, especially for chronic illnesses. While many factors can influence adherence, it is difficult to predict. Pharmacists are well-positioned to improve adherence through patient education about their medications, potential side effects, and the importance of adherence. Strategies like simplifying dosing regimens, using medication organizers, and addressing specific barriers can also help. Further research is still needed to better understand and promote adherence.
Medication adherence refers to the extent to which a patient follows medical advice regarding prescribed medications. It is important for therapeutic outcomes, especially for chronic illnesses. While many factors can influence adherence, it is difficult to predict. Pharmacists are well-positioned to improve adherence through patient education about their medications, potential side effects, and the importance of adherence. Strategies like simplifying dosing regimens, using medication organizers, and addressing specific barriers can also help. Further research is still needed to better understand and promote adherence.
Pharmacovigilance involves monitoring the safety of medicines through activities like safety reporting. It aims to detect adverse drug reactions and ensure the safe use of medications. Pharmacovigilance emerged in the 1960s in response to the thalidomide tragedy and involves collaboration between healthcare stakeholders. It focuses on collecting, analyzing, and communicating information on drug safety to regulatory authorities, healthcare providers, and patients.
This document discusses guidelines for rational and appropriate pharmacotherapy in geriatric patients. It notes that older patients are more susceptible to adverse drug effects due to multiple illnesses, physiological changes, and reduced organ function. When prescribing for older adults, doctors should balance potential harms and benefits, regularly review prescriptions, use appropriate formulations, avoid symptomatic prescribing, consider non-prescribed medications, anticipate pharmacological differences in aging bodies, and be aware that adverse drug reactions may present atypically. The guidelines emphasize cautious, individualized prescribing tailored to each older patient's needs and risks.
This document discusses the importance of proper drug administration in nursing practice. It outlines the traditional five rights of drug administration - right client, right drug, right dose, right time, right route - as well as five additional rights including right assessment, right documentation, patient's right to education, right evaluation, and patient's right to refuse. It emphasizes that nurses are accountable for safely administering medications by verifying orders, understanding each drug's effects and interactions, and ensuring patients provide informed consent before treatment.
Drug utilization evaluation(DUE) & Drug utilization review)Pooja Anothra
Drug utilization evaluation (DUE) is a systematic, ongoing evaluation of drug therapy that ensures medications are used appropriately and meet current standards of care. The goals of DUE include promoting optimal medication therapy, creating guidelines for appropriate drug use, and controlling costs. The DUE process involves establishing responsibility, developing review criteria, collecting and analyzing data, providing feedback to prescribers, and conducting follow-up evaluations. Drug utilization review (DUR) similarly involves ongoing review of prescribing, dispensing, and drug use, and can be prospective, concurrent, or retrospective to identify problems and improve medication therapy.
The document provides an overview of clinical pharmacy, including its definition, development, scope, and the functions and responsibilities of clinical pharmacists. It discusses key aspects of clinical pharmacy practice such as medication chart review, clinical review, pharmacist intervention, ward round participation, medication history, and pharmaceutical care. The summary is as follows:
Clinical pharmacy deals with the safe and effective use of drugs in patient care. It aims to optimize medication use and promote health. Clinical pharmacists are involved in medication monitoring, patient education, and ensuring rational drug therapy.
Key responsibilities of clinical pharmacists include collecting patient data, identifying drug-related problems, establishing treatment goals, evaluating and modifying drug regimens, and monitoring treatment outcomes.
This document discusses patient medication adherence. It defines adherence as taking medication as recommended by a healthcare provider. Non-adherence can be unintentional due to complex regimens or intentional if a patient stops medication. The World Health Organization identified 5 dimensions that influence adherence: social/economic factors, healthcare system factors, condition-related factors, therapy-related factors, and patient-related factors. Methods for measuring adherence include medication monitors, patient self-reports, pill counts, pharmacy records, and the Morisky Medication Adherence Scale. Pharmacists can improve adherence through education, simplifying regimens, identifying barriers, and reminding patients.
hOME MEDICATION REVIEW IS out standing self-employment opportunities with good clinical skills and hand on practice for pharm d students..its well an established program in Australia.
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Dive into an in-depth exploration of the histological structure of female reproductive system with this comprehensive lecture. Presented by Dr. Ayesha Irfan, Assistant Professor of Anatomy, this presentation covers the Gross anatomy and functional histology of the female reproductive organs. Ideal for students, educators, and anyone interested in medical science, this lecture provides clear explanations, detailed diagrams, and valuable insights into female reproductive system. Enhance your knowledge and understanding of this essential aspect of human biology.
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8 Surprising Reasons To Meditate 40 Minutes A Day That Can Change Your Life.pptxHolistified Wellness
We’re talking about Vedic Meditation, a form of meditation that has been around for at least 5,000 years. Back then, the people who lived in the Indus Valley, now known as India and Pakistan, practised meditation as a fundamental part of daily life. This knowledge that has given us yoga and Ayurveda, was known as Veda, hence the name Vedic. And though there are some written records, the practice has been passed down verbally from generation to generation.
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Basavarajeeyam is a Sreshta Sangraha grantha (Compiled book ), written by Neelkanta kotturu Basavaraja Virachita. It contains 25 Prakaranas, First 24 Chapters related to Rogas& 25th to Rasadravyas.
4. Definition of medication adherence
"Medication adherence is defined as the extent to which patients take medication
as prescribed by their doctors.
This involves factors such as getting prescriptions filled, remembering to take
medication on time, and understanding the directions."
"A patient is considered adherent if they take 80% of their prescribed medicine(s).
If patients take less than 80% of their prescribed medication(s), they are
considered nonadherent."
The American Pharmacists Association says medication adherence is "... the
extent to which a patient's behavior (e.g., taking medications with respect to
timing, dosage, and frequency) corresponds with agreed-upon recommendations
from a healthcare provider."
7. 1. Social/economic factor
Social and economic factors such as poverty or financial stress, transportation
challenges, cultural beliefs, medication costs and inadequate insurance are significant
drivers of medication nonadherence.
2. Therapy related factors
Therapy-related factors like complex therapy regime, taking different medications at
different times of day, frequent changes in medication regime or long duration of
treatment and side effects of medications are also major barriers to adherence.
8. 3. Patient related factors
Patient-related factors like forgetfulness, physical impairments, beliefs about medication and
low health literacy also impact the ability to optimize medication therapy.
Lack of knowledge about the disease and the reasons the medications are needed, lack of
motivation and substance abuse also are associated with poor medication adherence.
4. Condition related factors
Condition-related factors are related to the level of disability (physical, psychological, social
and vocational), rate of progression and severity of disease.
Health care team and system-related factors like lack of training on chronic diseases, poor
communication between the physician and patient regarding the benefits of the medication,
instructions for use and medication side effects can adversely affect medication adherence.
10. Direct methods of measurement
Measurement of the level of a drug or its metabolite in blood or urine and detection or
measurement of a biological marker added to the drug formulation, in the blood.
Direct approaches are one of the most accurate methods of measuring adherence but are
expensive.
11. Indirect method
It includes patient questionnaires, patient self reports, pill counts, rates of prescription
refills, assessment of patient’s clinical response, electronic medication monitors,
measurement of physiologic markers, as well as patient diaries.
Each method has its own advantages and disadvantages and no method is
considered as the gold standard.
The simplest way of measuring adherence is from the patient’s self report.
Among the various methods questioning the patient, patient diaries and assessment of
clinical response are all methods that are relatively easy to use, but questioning the
patient can be susceptible to misrepresentation and tends to result in the health care
provider overestimating the patient’s adherence.
13. 1. Level of prescribing
● Introduce a collaborative approach with the patient at the level of prescribing
Whenever possible, involve patients in decision making regarding their medications so that they
have a sense of ownership and they are partners in the treatment plan.
● Simplify medication taking
Use the most possible simplified regimen based on patient characteristics at the first level of
drug use.
14. 2. Communicating with patient
● Explain key information when prescribing/ dispensing a medicine
Address the key information about the drugs (what, why, when, how,
and how long). Inform the common side effects and those that
patient should necessarily know (Patients would be more worried
and lead to non adherence due to side effects that was not
cautioned to them in advance by health care professionals)
● Use medication adherence improving aids
Provide medication calendars or schedules that specify the time to
take medications, drug cards, medication charts or medicine related
information sheets.
15. ● Provide behavioral support
Collaborate with patient to incorporate the medication regimen into his/her daily regimen
(essential in those on complex drug regimens, those having unintentional difficulties in
adherence e.g. elderly)
3.during follow ups
● Schedule appropriate follow up Monitoring the medication adherence should also be a criteria
while scheduling patient follow up
● Assess adherence during consequent follow ups Measure adherence by various methods
which may be dependent on patient as well as drug characteristics. Check the effectiveness
of medication adherence aids used, if any. This should be done by physicians as well as
pharmacists.
● Identify difficulties and barriers related to adherence Address the problems
● Inform the patients accordingly how the problems have been addressed Patient involvement
in decision making is essential in improving medication adherence.
16. 4. Smart options
The rise of new technologies gives the industry powerful new ways to improve medication
adherence.
• Pharmacy incentive programs, such as Walgreens’ Balance Rewards for Healthy Choices,
which provide a set of web, app and text-based programs designed to improve medication
adherence, promote engagement and encourage immunizations.
• In-home telemonitoring that utilizes remote patient monitoring programs to monitor
medication adherence in high risk patients.
17. Innovative medication packaging as offered by PillPack, designed to help patients manage
multiple medications through convenient packaging, modern technology and personalized
service.
• In-home dispensing devices that create reminders and pre- packaged, unit-dose
medications in conjunction with a clinician portal and caregiver app to enable providers to
quickly flag non adherent patients and connect them to a healthcare professional
• Mobile apps that periodically remind patients to take their medications, connect patients
and pharmacists for collaborative care and initiate notifications to a patient’s family if the
person has not taken prescribed medications.
18. “Smart Bottle Caps” that fit standard drugstore containers. The lids register when they’re
removed and log each event in an app to provide real-time oversight by specialty
pharmacists and care coordinators, who can contact the patient if there’s a problem.
“Smart Pills” such as those under the AbilifyMyCite label that incorporate sensors that
track ingestion and send a signal to a wearable patch. The data transfers to a cloud-based
health record to track adherence, with patients deciding who receives their information.
20. WHO scenerio
Strong evidence shows that many patients with chronic illnesses have difficulty adhering to
their recommended medication regimen. Believing that medication nonadherence is the
“fault” of the patient is an uninformed and destructive model that is best abandoned. As
the former Surgeon General C. Everett Koop reminded us,
“Drugs don't work in patients who don't take them.” Thus, physicians must recognize that
poor medication adherence contributes to suboptimal clinical benefits, particularly in light
of the WHO's statement that increasing adherence may have a greater effect on health
than any improvement in specific medical treatments. The multifactorial nature of poor
medication adherence implies that only a sustained, coordinated effort will ensure optimal
medication adherence and realization of the full benefits of current therapies. Current
recognition of the importance of medication adherence has resulted in the development of
many useful Web-based resources.
21. Following are some patient referrals that doctor take into consideration :
● Education of both the patient and physician is important for medication adherence
● The physician should avoid prescribing numerous medications and behavioral
modifications at any one visit because this may overwhelm the patient and induce a
sense of futility
● The more empowered patients feel, the more likely they are to be motivated to
manage their disease and adhere to their medications.
● Involvement of patient in treatment decisions like to ask what time of day they would
prefer to take their medications. One patient may be more likely to adhere to his or
her medications if they were taken in the evening, whereas for another, the morning
may be preferred
22. ● To help combat poor health literacy and its negative effect on medication adherence,
a “shame-free” environment must be created.
● Consideration of patients' economic status is of paramount importance.
● By asking the appropriate questions, physicians can accurately assess which
medications patients are taking and how they are taking them.