PATIENT

MEDICATION
ADHERENCE
 OBJECTIVES
At the end of the session, you will be able to
 Define patient medication adherence (PMA)
 List out factors affecting PMA
 Explain the contribution of each factor in PMA
 Role of pharmacist in improving PMA
 FAMILY SAID DID NOT
NO TO UNDERSTAND
FORGOT
MEDICATION AWAY INSTRUCTIONS
or TOO
FROM BUSY
HOME
TAKING
PILL
HOLIDAYS UNABLE
TO CARE
FOR SELF
RAN OUT
OF PILLS SLEPT
IN
WENT FOR
PRAYERS
MISSED DOSES
AND GOT
CURED FEAR SIDE
EFFECTS
FELT ILL FELT
DID NOT BETTER
WANT PILLS DO WHAT TO DO?
OTHERS TO NOT HELP • No double dose
SEE • Within 3 hours, take the
missed dose
• If >3 hours, go for the next
WHY IT IS IMPORTANT ?
 DEFNITION
“Patient adherence can be defined as
the extent to which a patient takes or
uses his medication in accordance
with the intension of the medical or
health advise given”
• Patient takes medicines correctly: right dose,
right frequency, and right time.
• Patient is involved in deciding whether or not to
take the medicines.
• Compliance is the patients’ doing what they
have been told by the doctor/pharmacist.
FACTORS AFFECTING PATIENT
MEDICATION ADHERENCE
 TYPE OF DISEASE

 Psychiatric patients may not have the ability to

cooperate with the treatment
 When they become asymptomatic or symptoms subside
 Chronic conditions like Rheumatoid Arthritis
 PHYSICAL LIMITATIONS
 Distance – Long distance to procure the medications
 Need of assistance or help – eye drops, inhalers
 Difficulty in swallowing
 Poor Memory
 THERAPEUTIC REGIMEN
 The more complex the therapeutic regimen, less will
be the adherence.

Patient
Adherence
 ADVERSE EFFECTS
 Leads to stop medication
 Warnings about side effects makes the patients to
disagree to take medication
 Quit alcohol while medication, also leads to avoid drug
therapy
 COST OF MEDICATION
 May ask to pharmacist “which is important out
of this”
 Patient may reduce the frequency

TASTE OF MEDICATION
 Mainly in Pediatric oral liquids
 More unpalatable ….more chance to miss or
discontinued soon
 DIFFICULTY IN ADMINISTRATION
OF MEDICATION
 Incorrect measurements
 Inappropriate device usage
 Methods of Measuring Adherence

• Self-reporting
• Pill counts
• Pharmacy records
• Provider estimate
• Pill identification test
• Biological markers
• Measuring medicine levels—TDM
Adherence Counseling: Multidisciplinary Team

Adherence nurse
Doctors Adherence
message for the
patient
Counselor Social
Pharmacist worker
Family and
friends

Source: Horizons/Population Council, International Centre for Reproductive Health, and Coast Provincial General
Hospital, Mombasa, Kenya. 2004. Adherence to Antiretroviral Therapy in Adults: A Guide for Trainers . Nairobi:
Population Council.
 7. USE OF MEDICATION AIDS
 Pill reminder
 Refill reminders
 Calendar / Blister packs
7. USE OF MEDICATION AIDS
Thank you