Definition
The World Health Organization (WHO) defines medication adherence as:
“The extent to which a person’s behavior in taking medicines corresponds with the agreed recommendations from a healthcare provider.”
This means the patient takes the right medicine, in the right dose, at the right time, for the right duration — exactly as advised.
Factors Affecting Medication Adherence
WHO states that medication adherence is a multi-dimensional concept. The factors affecting adherence are grouped into five categories:
- Social and economic factors
- Health care system factors
- Condition-related factors
- Therapy-related factors
- Patient-related factors
1. Social and Economic Factors
These include:
- Low health literacy
- Lack of family or social support
- Unstable living conditions (e.g., homelessness)
- Busy work schedules
- Limited access to healthcare or pharmacy
- High cost of medicines
- Cultural beliefs about illness or treatment
2. Health Care System Factors
These include issues within the healthcare system such as:
- Poor patient–provider relationship
- Poor communication by the provider
- Mismatch between the beliefs of doctor and patient
- Inadequate patient education
- Lack of disease management programs
- Lack of continuity of care
3. Condition-Related Factors
These depend on the type of illness:
- Symptoms may improve, so the patient stops medicine
- Depressed patients may lose interest in taking medicines
- Patients with psychiatric disorders may forget doses
4. Therapy-Related Factors
Factors related to the treatment itself:
- Complex treatment regimens
- Medicines requiring technique (inhalers, injections)
- Long treatment duration
- Frequent changes in prescriptions
- No immediate benefit felt by the patient
- Social stigma about certain medicines
- Unpleasant side effects
- Interference with daily lifestyle
5. Patient-Related Factors
Factors specific to the patient include:
- Visual, hearing or cognitive impairment
- Poor mobility or difficulty swallowing
- Poor understanding of disease and medicines
- Lack of motivation
- Fear of side effects
- Stress, anxiety or anger
Formula to Calculate Medication Adherence
Medication Adherence (%) = (Number of doses taken / Number of doses prescribed) × 100
Role of Pharmacist in Improving Medication Adherence
Pharmacists play an important role in improving patient adherence. They can:
- Identify and help remove healthcare system barriers
- Educate patients about the benefits and importance of medicines
- Explain how to adjust the regimen to fit daily routine
- Address fears related to side effects
- Provide counseling and clarify doubts
- Motivate patients through follow-ups
- Identify reasons for non-adherence and offer solutions
Research shows that pharmacist-led counseling can significantly improve medication adherence behavior.
Detailed Notes:
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