Assessing medication adherence: options to consider (original) (raw)
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International Journal of Basic & Clinical Pharmacology
Background: Adherence is a key factor associated with effectiveness of all pharmacological therapies. Medication non-adherence is a significant barrier to achieve positive health outcomes especially for patients suffering from chronic diseases. Improving medication adherence is a public health priority and could reduce economic and health burdens. The aim of the present study was to assess medication adherence to some common chronic ailments.Methods: Pre-validated questionnaires were distributed among 300 patients suffering from chronic illnesses, by simple randomization out of which 240 patients returned completely filled questionnaires. The analysis was done by manual calculators, VassarStats, and SPSS V20. Results were calculated using univariate linear regression, with each patient’s adherence score as the dependent variable and each predictor as the independent variable. Results are expressed in frequencies and percentages.Results: In this study, 46.66% patients were males and ...
Patient Preference and Adherence, 2022
To provide an overview of instruments that measure adherence to medications to facilitate selection of an instrument and to provide a summary of some published adherence assessment tools tailored to be used by the healthcare team, especially the pharmacists. Data Sources: Studies were identified via PubMed, Medline, Embase, and Google Scholar using the search terms medication adherence, compliance, persistence, combined with the terms questionnaire, scale, survey, self-report, and instrument. Study Selection: Articles written in English, describing questionnaire instruments that were psychometrically evaluated (reporting a good coefficient of internal consistency, reliability assessed through Cronbach's alpha, and had been validated against a subjective or objective measure), and containing 30 or fewer items were included. Data Synthesis: Twelve instruments were identified and included in this review. Instruments were reviewed by evaluating specific characteristics (number of items, sample size, reliability, sensitivity, specificity, questionnaire completion time, criterion validity, and component analysis). Conclusion: Various instruments are used to assess patient adherence to medications; however, no single one performs well on all criteria. Every instrument has different advantages and unique properties. A particular instrument can be chosen after considering certain factors, such as the specific requirements, population, the needed time to complete the questionnaire, the sensitivity, and the specificity of the questionnaire. Moreover, there is a recognized need to provide primary care medication adherence services customized to patient's needs. A link for teamwork between healthcare providers such as pharmacists and patients is needed. This link can be a validated instrument to assess patient's adherence to medication.
Assessment of medication adherence in chronic diseases
International Journal of Research in Pharmaceutical Sciences, 2020
Majority of people with chronic diseases have poor adherence to their therapeutic regimen. It can result in various complications physialogically with undesirable metabolic conditions. The main objective of this study is to assess the level of satisfaction attained after medication in comorbidities (either having diabetes only or having hypertension only or having Hypertension and Diabetes) and also focussed on creating awareness in patients who do not follow the medication. A prospective cross sectional study was conducted at tertiary care hospital, Khammam, Telangana. 200 patients were approached and were interviewed with their consent. The purpose of the same was to collect the information on socio demographics, medication that is followed, and behavioural characteristics. A structured questionnaire MMAS-8 an eight itemed scale was involved to identify individuals, determine their levels, the reliability and validity of the medication followed. The scrutiny of this study found th...
BMC Medical Research Methodology, 2011
Background: There is a recognised need to build primary care medication adherence services which are tailored to patients' needs. Continuous quality improvement of such services requires a regular working method of measuring adherence in order to monitor effectiveness. Self report has been considered the method of choice for clinical use; it is cheap, relatively unobtrusive and able to distinguish between intentional and unintentional nonadherence, which have different underlying causes and therefore require different interventions. A self report adherence measure used in routine clinical practice would ideally be brief, acceptable to patients, valid, reliable, have the ability to distinguish between different types of non-adherence and be able to be completed by or in conjunction with carers where necessary.
Medication Adherence Measures: An Overview
BioMed Research International, 2015
WHO reported that adherence among patients with chronic diseases averages only 50% in developed countries. This is recognized as a significant public health issue, since medication nonadherence leads to poor health outcomes and increased healthcare costs. Improving medication adherence is, therefore, crucial and revealed on many studies, suggesting interventions can improve medication adherence. One significant aspect of the strategies to improve medication adherence is to understand its magnitude. However, there is a lack of general guidance for researchers and healthcare professionals to choose the appropriate tools that can explore the extent of medication adherence and the reasons behind this problem in order to orchestrate subsequent interventions. This paper reviews both subjective and objective medication adherence measures, including direct measures, those involving secondary database analysis, electronic medication packaging (EMP) devices, pill count, and clinician assessme...
Adherence to Prescribed Medications among Patients with Chronic Diseases
Introduction: Multiple medications are prescribed to patients with chronic diseases making adherence an ongoing struggle for both patients and healthcare professionals. Hence, our aim was to evaluate the medication adherence level among patients with chronic diseases in Kelantan, Malaysia. Methods: We conducted a cross-sectional study from April 2017 until March 2019. Our inclusion criteria were adult patients with documented chronic diseases, treated in government hospitals and health clinics in Kelantan and on medications for at least one year. As for the intervention group, it consisted of patients who had at least 4 visits to the pharmacist-managed Diabetes Medication Therapy Adherence Clinic (DMTAC). Patients who were pregnant, breastfeeding, diagnosed with psychiatric disorders and those who were illiterate or unable to understand Bahasa Malaysia were excluded. The validated Malay version of Medication Compliance Questionnaire (MCQ) was used to measure medication adherence. Data were analyzed using SPSS version 20.0. Results: We recruited a total of 275 patients (control, n=144; DMTAC, n=131). Most of them were Malay (n=268, 97.5%), female (n=173, 62.9%) with mean (SD) age of 55.6 (11.4) years old. Mean (SD) medication adherence score for our study population was 88.7 (9.9) with 83.6% (n=230) patients were adherent. There was a significant difference in terms of medication adherence level when compared between both groups (p=0.036). Thirty (10.9%) patients were non-adherent in the control group while 15 (5.5%) patients were non-adherent in the intervention group. Conclusion: Overall, most of our patients with chronic diseases were adherent to their medications. Further research is warranted to determine factors associated with medication adherence.
Patient self-reported adherence for the most common chronic medication therapy
Scandinavian Journal of Public Health, 2013
Aims: The aims of this study was to determine adherence to chronic disease medication measured by self-reported questionnaire. Methods: The survey was conducted at 106 Zagreb pharmacies, and the questionnaire was filled out by the study subjects. Results: A total 1,357 diagnoses were reported by survey respondents (i.e., an average of 2.1 diagnoses per respondent). The most common diagnoses were diseases of the circulatory system (n = 500; 36.8%). The great majority of study subjects reported forgetfulness ('I just forgot') as the main reason for skipping drug doses. Conclusions: Among the many reasons people give for not adhering to drug treatment, forgetfulness was the most common. Common barriers to adherence are under the patient's control, so that attention to them is a necessary and important step in improving adherence. The existence of more than one cause of risk considerably increases the non-adherence risk of a patient.
Patient preference and adherence, 2017
There is little debate that medication nonadherence is a major public health issue and that measuring nonadherence is a crucial step toward improving it. Moreover, while measuring adherence is becoming both more feasible and more common in the era of electronic information, the reliability and usefulness of various measurements of adherence have not been well established. This paper outlines the most commonly used measures of adherence and discusses the advantages and disadvantages of each that depend on the purpose for which the measure will be used. International consensus statements on definitions and guidelines for selection and use of medication adherence measures were reviewed. The quality of recommended measures was evaluated in selected publications from 2009 to 2014. The most robust medication adherence measures are often ill suited for large-scale use. Less robust measures were found to be commonly misapplied and subsequently misinterpreted in population-level analyses. Ad...
A Community Based Study on Assessment of Medication Adherence in Patients with Chronic Diseases
https://www.ijhsr.org/IJHSR\_Vol.10\_Issue.6\_June2020/IJHSR\_Abstract.020.html, 2020
Medication adherence is defined by the World Health Organization as "the degree to which the person"s behaviour corresponds with the agreed recommendations from a health care provider. According to WHO there are multiple factors leading to poor medication adherence, normally classified as socioeconomic factors, therapy related factors, patient related factors, condition related factors and health system/ healthcare team related factors. The present study aimed to assess medication adherence among patients with chronic diseases. And it also reviews various barriers for non-adherence. A prospective observational study was conducted for a period of 6 months in the community of Mangaluru. A validated Morisky medication adherence questionnaire (MMAS-8) for assessing medication adherence was prepared and the survey was conducted. This study covered 207 participants who were under treatment for chronic diseases. Out of 207 patients the number of males participated were found to be 126(61%) and females were 81(39%). Study revealed that 91(43.97%) are low adherent while 68 (32.85%) are moderately adherent and 48 (23.18%) are highly adherent to their prescribed therapy. In this study, the most common reasons associated with non-adherence were found to be age, forgetfulness, co-morbidity, patient felt better and pill burden (polypharmacy). From the data, out of 207 only 91 have received counselling and 82 of them fell under medium& high category, which means counselling is progressive & it improves adherence. The effectiveness of a treatment depends on both the efficacy of a medication and patient adherence to the therapeutic regimen. Patients, healthcare providers and health care systems, all have a role to improve medication adherence.
The American Journal of the Medical Sciences, 2007
International recommendations such as the CONSORT and International Conference on Harmonisation statements recognize patient adherence to prescribed treatment as an important aspect of a treatment's evaluation, but this issue is little assessed. To evaluate how medication adherence was assessed and reported in recently published randomized controlled trials (RCTs). All publications of RCTs assessing pharmacological treatments in 6 major chronic diseases published in high-impact-factor journals in 2003 and 2004 were selected from the Medline database. Two investigators analyzed how medication adherence was assessed and reported. A total of 192 publications were analyzed: 71 in HIV infection, 48 diabetes mellitus, 24 rheumatoid arthritis, 23 asthma, 15 hypertension, 7 osteoporosis, and 4 about 2 of these diseases. The assessment of medication adherence was documented in 69 (35.9%) publications, by counting pill intake in half of these. Results of adherence were reported in 64 (33.3%) publications. Adherence was reported as a quantitative measure: Proportion of the treatment prescribed in 27 articles and as a qualitative measure (adherent patient, yes/no) in 41 (in 4 reports both techniques were used). When reported, the median intake of prescribed medication was 93%, and the median proportion of "nonadherent" patients was 6.2%. There is important variability in the assessment and reporting of medication adherence in published RCTs of pharmacological treatments of selected chronic diseases, for a given disease and across diseases. Standardization is advisable to allow for comparisons among studies.