Adhering to medicines

Question 1

What is adherence?

Answer 1

• Adherence is defined as the extent to which the patients action matches the agreed recommendations
• Non-adherence is when patients don’t follow the doctors recommendations e.g. not taking the medications at the given time

Question 2

What are the 2 reasons for patient adherence?

Answer 2

• Intentional: the patients perception of drugs
• Unintentional: the barriers outside the patients control

Question 3

What does intentional non-adherence include?

Answer 3

• Personal beliefs
• Media claims
• Patient motivation
• Adverse effects

Question 4

What does personal beliefs include?

Answer 4

• In some religions such as Judaism, Hinduism and Islam they don’t allow their followers to consume certain foods and drinks
• In the islamic religion, people have to follow the dietary laws which include eating halal foods however if the medications contain halal such as gelatine people may not take this medication as it contains ingredients
• certain medications contain ingredients where the religion prohibits you to have such as the gelatine in capsules for example the religion Islam prohibits gelatine
• Some religions such as Judaism and Hinduism expect their followers to fast however this may interfere with the medications that patients may have to take

Question 5

What does media claims include?

Answer 5

• If there are media claims around certain medications this may influence the patients decisions
• An example of a media claim is:
• COVID-19 vaccine
• MMR vaccine - Wakefield falsely made a link between autism and the MMR vaccine and then the media then published this to get a greater audience which then influenced patients decisions

Question 6

What does patient motivation include?

Answer 6

• it is important for patients to take the full course of antibiotics because if they don’t this could eventually lead to drug resistance
• Many patients may feel better after only taking half of the medication so they then therefore may stop continuing with the course

Question 7

What does adverse effects include?

Answer 7

• Patients may experience adverse effects and this may cause a patient to stop taking the medication before the course is over as the adverse effects may be worse than having the illness

Question 8

What are some examples of unintentional non-adherence?

Answer 8

• Barriers to understanding
• Mental health

Question 9

Mental health

Answer 9

!!

Question 10

What does barriers to understanding include?

Answer 10

• Patients who need to take multiple drugs at different times (Polypharmacy) during the day they may become confused on what drugs to take at what time so there are multiple aids which can help with this such as a medication box
• Patients who have a mental impairment such as dementia, Alzheimer’s or poor recall of instructions may not fully understand when to take the drugs or may not remember to take the drugs at a certain time. there are multiple aids which can help with that such as a phone alarm everyday to remind them
• Language barriers - if patients speak a different language to the doctor then the patients may not understand what they say and they then may misunderstand what the doctor says

Question 11

Example on how to improve patient adherence:

Answer 11

• Patient education - if patients are more educated on medication then this would improve adherence as the patients know that to expect
• Educating the patients on the benefits and consequences of adhering to medication - if patients know the benefits and consequences of adhering, they are more likely to adhere to the medication

Question 12

What are the other ways to improve adherence (S.I.M.P.L.E)?

Answer 12

• Simplifying regime characteristics
• Imparting knowledge
• Modifying patient beliefs
• Patient communication
• Leaving the bias
• Evaluating adherence