Medication Adherence Support in Aotearoa New Zealand: No Central Policy, No Ownership, No Accountability

BackgroundMedicines constitute the fulcrum of therapy across diseases, with patients needing to follow prescribed regimens (practice medication adherence (MA)) to derive optimal clinical benefits from medications. Poor MA is linked with increased mortality, morbidity and health costs, worse disease outcomes and reduced quality of life. Aotearoa New Zealand (NZ) operates a publicly funded health/medicines system, but available MA supports are unclear.MethodsUsing document analysis, this narrative review collated MA interventions and strategies recommended in several broad NZ health and medicine -specific policies to outline the NZ MA policy landscape for the first time. Eight policy documents underwent document analysis to identify proposed MA-related interventions and the responsible bodies.ResultsThe identified interventions targeted health system, socioeconomic, disease, therapy and patient-specific factors. Incorporating MA promotion across the health system (in IT platforms, MA services and others) by all healthcare professionals, pharmacists especially, was central to the interventions, as was including patients in medicines therapy decisions via robust communication. The interventions aligned with the MA needs of NZ chronic disease patients, indicating that implementing them could improve patients' MA. The lack of a national MA policy or responsible entity and other policy gaps, however, appeared to hinder implementation, ownership and accountability.ConclusionThe wide-ranging MA promotion interventions recommended across NZ health and medicines policies need implementation which would require multipronged efforts of stakeholders across government and the pharmacy/health sectors.