What is medication adherence?

Medication adherence and medication compliance are two terms that we often hear about in healthcare.

Adherence usually refers to filling a new prescription or refilling prescriptions on time. Compliance means taking the medications regularly as prescribed. The terms, however, are often used interchangeably. To be adherent/compliant means that the patient is taking their medication regularly and as prescribed.

Medication adherence is a very important part of managing chronic conditions.

Why is medication adherence important?

Research has shown that improving medication adherence may have a greater influence on the health of our population than in the discovery of any new therapy. Treatment of a chronic disease requires long term treatment with medications. While these medications are effective to help with the disease progression, adherence is crucial to get their full benefit.

Studies have shown that almost 50% of adults in the US are non-adherent to medication and over 10% of hospital and nursing home admissions are due to non-adherence to medications for chronic conditions such as diabetes and hypertension. An article published in 2018 states that non-adherence can account for up to 50% of treatment failures or around 125,000 deaths and up to 25% of hospitalizations each year in the United States.

A report from the World Health Organization states, “Medicines will not be effective if patients do not follow prescribed treatment, yet in developed countries only 50% of patients who suffer from chronic diseases adhere to treatment recommendations. In developing countries, when taken together with poor access to health care, lack of appropriate diagnosis and limited access to medicines, poor adherence is threatening to render futile any effort to tackle chronic conditions.”

Poor adherence can result in avoidable consequences such as:

• reduced functional abilities and quality of life
• unnecessary disease progression
• additional medical costs
• increased physician visits

What is the reason for non-adherence?

A survey conducted in 2019 identified the following as top reasons for medication non-adherence:

• access to a pharmacy
• price of medications
• ability to track refills
• fear of side effects
• belief that the medication is not beneficial
• patient has “too many pills” to take

Adherence is a complex issue. There are a lot of external factors that can impact medication adherence. Ideally, any patient who is adherent to their medication 80% or more is considered to be adherent.

How to improve medication adherence?

Given the complex nature of the problem, there is no one correct answer to this question. Each patient may be facing a different issue which is preventing them from medication adherence. Following are some options that can be utilized to help with adherence.

• Talk to your health care provider. If you are worried about side effects or the costs of your medications or if you feel like the frequency of the dosing is challenging for you, discuss your concerns with your doctor or pharmacist. Your healthcare team may be able to provide coupons or switch you to other agents that may be better suited for you.
• Use reminder tools to help you remember. If you have a lot of pills to take at different times throughout the day or generally forget to take your medication, you would benefit from using a reminder tool. Some commonly used methods are:
  • setting an alarm for each time you need to take a medication.
  • keeping your pill bottles in areas where you are usually at during those times.
  • using a pill box to have your medications sorted by the time of the day.
• Keep an updated list of medications with the dosing instruction. Most pharmacies now offer medication reconciliation. Utilize this service to obtain an updated list of your medications. You can use the list to make sure you are taking all the medications you are prescribed. Take the list with you to every doctor’s appointment and request the doctor’s office provide you with an updated list if they change anything.
• Get all you medications at one pharmacy. Using one pharmacy will help with your adherence and also allow the pharmacist to better understand your medication regimen to provide a better service. You can also use the pharmacy’s medication synchronization program so that you make the least possible trips to pick up your medications.

These are just some options that can be utilized to help with medication adherence. If you are struggling with your medication regimen, it is highly recommended that you share your concerns with your doctor or pharmacist to figure out a reasonable solution to help ease your concerns and also improve the management of your condition.

References:

https://pubmed.ncbi.nlm.nih.gov/27079345/

https://www.fda.gov/consumers/consumer-updates/are-you-taking-medication-prescribed

https://www.uspharmacist.com/article/medication-adherence-the-elephant-in-the-room

https://blog.cureatr.com/medication-adherence-vs-compliance-4-ways-they-differ

https://www.cdc.gov/mmwr/volumes/66/wr/mm6645a2.htm

https://www.who.int/chp/knowledge/publications/adherence_report/en/