Module 3-MEDICATION ADHERENCE Flashcards
AM
Morning
CI
Confidential interval
OR
Odd ratio
PRN
As needed
VTE
Venous thromboembolism
(DVT/PE) blood clots in a deep veins usually lower lakes, thigh, pelvis, arm)
Medication non-adherence: (2)
1- In the hospital,
2- After hospitalization
Medication non-adherence:
-1????
Patient declined medication example VTA prophylaxis, insulin)
Medication non-adherence
1-in the hospital
MEDICATION NON-ADHERENCE
2-??
-primary non-ADHERENCE ( patient never come pick up prescription at pharmacy )
-Taking does that a lower or less frequently than prescribe?
-Intermittently missed/forget doses.
-refill prescription late/gaps in treatment-
-Stop taking the medication before therapy is completed
Medication non-adherence.
2-after hospitalization
Primary non-adherence
-341 patients admitted with acute coronary syndrome or congestive heart failure, exacerbation, received Pharmacist counseling at discharge.
1-patient did not fill prescriptions after discharge
2-patient who is living alone more likely do not feel their medication compared to those who were married or co-habituating (OR 2.2)
3-patient who were discharged with greater than 10 medication were more likely to demonstrate primary non-adherence (OR 2.3)
Non-adherence: Factor:???
-(1) ????
-Poor physical health, FRAILTY
-Cognitive factors, does it dementia
-mental health conditions, example, depression, mania ,schizophrenia
-patient does not perceive the benefit of the medication, health, relieves, lack of inside into disease
-Misunderstanding therapeutic reason for the medication-
-Forgetfulness, attempting to lie on memory alone to take medication without prompts-
-changes to routine example traveling
-Intentional patient. ..ie. Patient chooses to not take medication’s.
Non-adherence: Patient factors: (1)
patient may have difficulty taking their medication due to:
Non-adherence :patient factors continue :??? (2)
-education.
-Income.
-Insurance coverage
-Medication cost
-unstable living situation/homeless
-lack of family or social support, and practical support.
-transportation – access to pharmacies and appointments, wait times.
-social stigma
Non-adherence (. continued)
patient factors:
2-Economic, and social factors impacting medication adherence
Non-adherence:
-Complex medication regiment.
-Polypharmacy example taking more than five medication’s.
-frequent changes to medication.
-high frequency dosing : patient taking medication more than once per day.
-In frequent dosing: taking medication less than once per day. e.g weekly, month, annually
-duration of therapy
-side effects
_
Non-adherence:
-medication specific and regiment factors impacting medication adherence
Non-adherence:
-Patient prescriber relationship, example priority in taking with provider about health issue
-given poor instructions example how to take medication.
-In adequate follow up.
-inconvenience of filling and filling prescriptions.
-difficulty with pharmaceutical supply chain, and availability of medication and pharmacies.
None adherence:
Health system factors
Improving medication adherence: (2)
-1 . During hospitalization:
—??
-2. After discharge
——??
-2 ??
-Pharmacist phone calls
-Motivational interviewing.
-tracking of prescription fills/refill.
-Medication synchronization (med sync) program
-The pharmacy align medication refills so that all medication can be picked up on a same-day, monthly, making multiple-choice trip to the pharmacy unnecessary
— Packaging or dispensing strategy like : pillbox, medication planner(simple, and smarter) Blister pack, individual dose, packaging, advanced technology
Medication non-adherence occurs secondary to patient medication specific and medication regimen and health system factor
Medication nonhumans can address through education provide to patients and their family and or other caregivers, I reach, tracking, medication, synchronization programs, and medication dispensing, and packaging strategies 
