{"id":24604,"date":"2022-03-08T10:32:43","date_gmt":"2022-03-08T15:32:43","guid":{"rendered":"https:\/\/www.thinkresearch.com\/ca\/?p=24604"},"modified":"2022-03-08T11:28:31","modified_gmt":"2022-03-08T16:28:31","slug":"improving-medication-non-adherence","status":"publish","type":"post","link":"https:\/\/www.thinkresearch.com\/ca\/2022\/03\/08\/improving-medication-non-adherence\/","title":{"rendered":"Improving Medication Adherence"},"content":{"rendered":"\n

Taking medications as prescribed is critical to improving health outcomes \u2013 especially for patients living with chronic diseases \u2013 yet many Canadians are unable to do so for a variety of reasons. On average, 20-30 percent<\/a> of prescriptions in Canada are never filled. When prescriptions are filled, nearly 26 percent<\/a> of Canadians admit to taking medications differently than prescribed, while 21 percent<\/a> say they\u2019ve stopped taking medications before advised, or without consulting their doctor.<\/p>\n\n\n\n

This can have serious consequences, both clinically and economically. Medication non-adherence results in billions of avoidable costs for healthcare systems around the world<\/a>, due to repeated hospital admissions and increased physician visits.<\/p>\n\n\n\n

\u201cMedications are prescribed in a particular way to optimize health outcomes,\u201d said Dr. Naila Kassam, primary care physician and Think Research\u2019s Senior Medical Advisor. \u201cWhether it\u2019s a certain dose to be taken at certain times, or at a specified frequency, it\u2019s all very important. Unfortunately, failure to take medications as prescribed can cause diseases and health conditions to worsen, so it\u2019s important to think about patient considerations such as cost and dosing frequency when starting a new medication.\u201d<\/p>\n\n\n\n

Why Patients Don\u2019t Adhere<\/strong><\/h2>\n\n\n\n

There are many reasons patients are unable to comply with prescriptions.  Some of the most frequently cited include:<\/p>\n\n\n\n

Cost<\/strong><\/h3>\n\n\n\n

Canadians deal with some of the highest medication costs<\/a> in the world, and while many individuals have private coverage through their employers, some provincial and territorial public plans include very high co-pays and deductibles. As a result, 1 in 10 Canadians<\/a> will not adhere to a prescription due to cost-related issues, with many identifying<\/a> high monthly medication costs, lack of coverage, and high out-of-pocket costs as the major barrier.<\/p>\n\n\n\n

Literacy and understanding<\/strong><\/h3>\n\n\n\n

Health literacy is defined as a patient\u2019s ability to access, process, and understand health-related information to make good health decisions. An estimated 60 percent<\/a> of Canadians lack sufficient health literacy skills, which can lead to decreased medication adherence. <\/p>\n\n\n\n

Age and level of education are regularly associated<\/a> with lower health literacy, with the issue being most problematic among patients older than 60, who are also most likely to be impacted by chronic diseases.<\/p>\n\n\n\n

Additionally, most healthcare material and instructions are written in a way that is often overly complex. Medical literature, including pamphlets, information on illnesses, consent forms, care plans, medication bottles, etc., are typically written at a grade 10 level, yet 48 percent<\/a> of Canadian adults have literacy skills that fall below a high school level.<\/p>\n\n\n\n

Feeling better<\/strong><\/h3>\n\n\n\n

As symptoms start resolving, it\u2019s not uncommon for patients to think their health condition has been corrected, and it\u2019s ok to stop taking medications. However, stopping medications abruptly or even lessening doses can cause conditions to worsen and\/or lead to unpleasant side effects. Patients should always take medications as directed and talk to their healthcare provider before changing doses or stopping altogether.<\/p>\n\n\n\n

\u201cIf symptoms start to subside, that\u2019s an indication the medication is doing its job,\u201d said Dr. Kassam. \u201cEven if patients are feeling better, they should always finish prescriptions or check with their doctor before making any changes.\u201d<\/p>\n\n\n\n

Undesirable side effects<\/strong><\/h3>\n\n\n\n

A number of medications create unpleasant side effects that patients wish to avoid. This can include a vast range of conditions, from dry mouth and weight gain, to nausea, diarrhea, and drowsiness.  Some side effects will go away as patients adapt to the new medication, however if side effects are lingering or causing too much discomfort, patients should speak with their doctor.<\/p>\n\n\n\n

Forgetfulness<\/strong><\/h3>\n\n\n\n

Forgetfulness is one of the most commonly reported<\/a> causes of unintentional non-adherence, with nearly 23 percent of Canadians admitting they have a problem remembering to take medications on a regular basis, especially when their care plan is complicated.    <\/p>\n\n\n\n

What Can Clinicians do?<\/strong><\/h2>\n\n\n\n

Though some non-adherence causes are harder to overcome than others, there are a number of things clinicians can do to improve medication adherence rates.  <\/p>\n\n\n\n

Communication<\/strong><\/h3>\n\n\n\n

Communication is key to improving medication adherence. It\u2019s critical that clinicians take the time to explain a patient\u2019s condition, the benefits of the medication, and the consequences of non-adherence in a way the patient will understand. Do not rely on literature alone to convey critical information to patients or their caregivers. <\/p>\n\n\n\n

Clinicians should also use open-ended questions when discussing adherence, as this approach has proven to elicit more informative responses. For example, instead of asking \u201cAre you taking your medication?\u201d ask \u201cHow do you think the medication is working for you?\u201d or \u201cWhat\u2019s the hardest thing about taking your medications?\u201d <\/p>\n\n\n\n

Simplify regimens<\/strong><\/h3>\n\n\n\n

Whenever possible, use the simplest level of prescribing. Also be sure patients are aware of any medication delivery services in their area. <\/p>\n\n\n\n

Discuss medication aids<\/strong><\/h3>\n\n\n\n

From calendars to phone apps and pill boxes, ensure patients are aware of the range of tools available to help organize and remind them to take medications.<\/p>\n\n\n\n

Schedule follow-ups<\/strong><\/h3>\n\n\n\n

Follow-up regularly with patients to discuss their condition and medication regimen. During visits, look for clues patients aren\u2019t adhering to medication as directed. Some signs include<\/a> regularly cancelling appointments, non-aligned pill counts, missed refills, escalating therapies without improvement in clinical measures, and the presence of depression or use of alternative medicines.<\/p>\n\n\n\n

Be understanding<\/strong><\/h3>\n\n\n\n

An estimated 83 percent of patients<\/a> would never tell a provider they weren\u2019t planning to fill a new prescription. Maintaining a supportive, blame-free environment where patients feel safe to openly discuss their condition and their prescription adherence, either by direct inquiry or questionnaires can improve adherence rates. <\/p>\n\n\n\n

\u201cCreating an environment where patients feel comfortable discussing treatment plans and potential barriers to adhering to medications is key to improving health outcomes,\u201d said Dr. Kassam. \u201cPicking up on signs of non-adherence can help correct the problem before conditions worsen.\u201d <\/p>\n\n\n\n

+   +  + <\/p>\n\n\n\n

Clinicians: Access free courses designed to help improve medication adherence and medication management. Join MDBriefCase today for free. <\/strong><\/a><\/p>\n\n\n\n

MDBriefCase is a member of the Think Research family of companies. <\/em><\/p>\n","protected":false},"excerpt":{"rendered":"

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