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Medication Adherence.pdf

  1. Medication Adherence By, Dr,Ravikiran.S Assitant Professor Assam Downtown University Chapter- 6
  2. DEFINATION Medication adherence occurs when a patient takes their medications according to the prescribed dosage, time, frequency and direction.
  3. Describe the importance of good adherence and the consequences when adherence is poor. Describe effective strategies to promote adherence and discuss how to help patients cope with non-toxic side effects of ARVs. Demonstrate ways to counsel patients about adherence. Develop a tool or questionnaire to measure adherence in your local context. OBJECTIVES:
  4. FACTORS INFLUENCING NON ADHERENCE: 1. The high cost of medicines: According to research, as medical costs go up, adherence goes down. It is understandable that patients will not take medicines if they cannot afford them in the first place. Healthcare providers must put in the effort to determine if a patient can afford the medicine being prescribed and help secure financial assistance for those who can’t.
  5. II. Lack of understanding about medicine regimen: When patients do not understand how or when to take medicine, they may skip some doses or totally avoid the medication. Such patients will benefit from meetings with their pharmacists to learn properly about their medication regimens. The pharmacists can help them create pill calendars and teach them how to use apps that remind patients about the medications. III. Side effect scares: Most medicines have some side effects or the other. Some of these negative effects wear off when the patient adapts to the new treatment while certain side effects may be long-lasting. In such cases, the patient may require additional treatment to address these side effects. Non-adherence increases when patients don’t know who to turn to or what to do when they experience such unpleasant or scary side effects.
  6. IV. Difficulty in refilling medication: Those suffering from chronic medical conditions will need to refill their medications on a regular basis. Non-adherence to medications occur when patients face difficulty in getting their prescriptions renewed. It can get quite frustrating when they have to make multiple calls to their physician’s office, wait on hold and navigate through complex phone trees only to be told to call again later. Centralized refill hotlines manned by pharmacists can solve such issues and ensure prescriptions are filled up without such hassles. V. Inconveniences in accessing medication: These factors determine whether or not the patient's family members, healthcare providers, the local community and society are supportive enough to assist in medication adherence. These may be negative or positive based on there behavior and attitude.
  7. STRATEGIES TO OVERCOME NON-ADHERENCE The effectiveness of a therapeutic regimen depends upon both the patient adherence and efficacy of the medicine. Thus, healthcare providers, as well as the system, have a great role in improving medication adherence. Improving in a single factor cannot provide a 100% success rate in compliance. There is a need to use a combination of various techniques to improve patient’s adherence to the prescribed therapy. Following are some approaches that can be implemented to improve compliance. 1. Level of Prescribing: For improving compliance there is a need to introduce two-way approaches during prescribing the medicine. Before prescribing the medicine, a doctor should discuss or ask the patient for a convenient preparation/dosage form and according to the possibility, a doctor should prescribe or change the treatment plan.
  8. At the time of prescribing or dispensing of drugs, the health practitioners should explain the key information such as; what, why, when, how, and how long to take medicine. The common side effects may result after the use of the regimen and if it is necessary to know to a patient then should be explained by health practitioners. To improve patient compliance then provide a medication calendar, medication chart, drug information sheet, special container indicating a time of dose, etc. To improve patient compliance, it is necessary to provide behavioral support. Sometimes there is also a need to collaborate with patients to incorporate the medication regimen in their daily schedule particularly when there is a complex therapeutic regimen and in elderly patients. 2. Communicating with the Patient: 3. By Simplifying Therapeutic Regimens: Many times, patients avoid or discontinue using drugs due to complex regimens. Doctors
  9. of drug administration. Doctors can prescribe a combination of drugs in a single tablet. Frequent administration of a drug can be avoided by prescribing sustain dosage forms or long-acting drugs. For example: sustain release glibenclamide and metformin in diabetes and morphine for chronic pain. The advantage of such kind of sustain released preparation is minimizing adverse effects. In certain conditions (diabetes, tuberculosis, HIV), compliance can be improved by educating the patients about their disease condition and the necessity of medicines for their treatment. Patient education is always to be encouraged if it improves compliance. A patient can also be helped by providing the leaflets for drug information and instruction to take the medicine particularly for ear drops, pessaries, and suppository. At each visit patients should bring their tablets with them this allows the doctors to know exactly what drugs the patient is taking. For monitoring the compliance as well as demonstrating the correct method of drug administration patient was asked to have the medicine in front of the Doctor. 4. By Educating the Patient: