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Understanding patient management: the need for medication adherence and persistence
1MBBS (Mal), FRCP (Eng) University of Malaya, Kuala Lumpur, Malaysia.
Insights
Poor medication adherence significantly impacts disease control, especially for chronic conditions like hypertension. Addressing patient, provider, and system barriers is crucial for improving adherence and reducing preventable deaths.
Area of Science:
- Pharmacology and Public Health
- Chronic Disease Management
Background:
- Poor patient adherence to medication is a primary driver of inadequate disease control, particularly in asymptomatic chronic conditions such as hypertension and dyslipidemia.
- Non-adherence imposes substantial physical and economic burdens on patients and healthcare systems, contributing to millions of preventable deaths annually.
Purpose of the Study:
- To highlight the significance of recognizing and identifying medication non-adherence as a critical first step in disease management.
- To explore the multifaceted barriers to medication adherence, encompassing patient-specific factors, healthcare provider influences, and systemic issues.
- To underscore the importance of developing and implementing effective strategies to overcome these barriers and improve patient adherence.
Main Methods:
- Review of existing literature on medication adherence measurement techniques, including self-report and electronic monitoring.
- Analysis of factors contributing to non-adherence within patient, provider, and healthcare system domains.
- Identification and synthesis of evidence-based strategies to enhance medication adherence.
Main Results:
- Medication adherence can be assessed through various methods, ranging from patient self-reporting to sophisticated electronic monitoring systems.
- Successful management of non-adherence requires a comprehensive approach that considers the complex interplay of patient-related, provider-related, and system-related barriers.
- Strategies such as patient education, improved patient-provider communication, optimized dosing schedules, development of drugs with fewer side effects, and enhanced healthcare accessibility are vital.
Conclusions:
- Improving medication adherence is essential for effective chronic disease management and reducing the global burden of preventable mortality.
- A collaborative approach involving patients and healthcare providers, with a focus on clear communication and shared decision-making, is fundamental.
- Simplifying drug regimens and addressing systemic barriers are key to empowering patients and enhancing long-term adherence.
Abstract:
Poor patient adherence to medication is one of the major factors contributing to poor disease control, in particular in asymptomatic chronic diseases like hypertension and dyslipidaemia. The physical and economic burden on patients and the health care system as a result of non-adherence is great. It is estimated that poor adherence to hypertension medication accounts for as many as 7.1 million preventable deaths annually. Hence recognising and identifying non-adherence is the first step to addressing this problem. Medication adherence can be measured in various ways including self-report to electronic monitoring. In order to be more successful in managing non-adherence, attention must be paid to barriers to adherence, namely the interplay of patient factors, the health care providers themselves and the health care system itself. Taking these into account will probably have the greatest impact on improving medication adherence. Consequently strategies to help overcome these barriers are of paramount importance. Some of these strategies will include education of patients, improving communication between patients and health care providers, improving dose scheduling, providing drugs with less adverse effects, and improving accessibility to health care. Poor mediation adherence continues to be a huge challenge. While the patient is ultimately responsible for the taking of medication, good communication, involving the patient in decision making about their care and simplifying drug regimens go a long way in improving it.
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