The best time to stress the value of medication adherence is when the patient receives the prescription from their provider. Patients consider their healthcare providers the most reliable source of information about their health condition and treatment. Therefore, they are more likely to follow treatment plans when they trust their healthcare team. Yet, research shows that there is a communication gap between patients and their healthcare providers – doctors, nurse practitioners, physician assistants and pharmacists – when it comes to talking about medications and the benefits and risks of prescription medicines.
Instructions that are too difficult to follow can lead to improper dosing or poor adherence to the dosing schedule. Not enough details or not answering the patient’s questions may lead to mistrust and poor adherence. It’s important healthcare providers respect their patients as meaningful members of their own healthcare team and include them in the decision-making process. Gaining a keen understanding of patients’ needs through effective patient-provider communication is vital when employing approaches to improving medication adherence.
Over a third of American adults are estimated to have basic or below-basic health literacy. This may result in their inability to read a medicine bottle label and/or remember all the instructions and safety information. Patients may also be reluctant to ask or are unaware of important questions to ask during a medical or pharmacy visit. This communication gap contributes to unnecessary side effects, drug interactions, non-adherence and costly disease complications.
Communication is Key
Healthcare providers should adopt universal precautions to help patients take their medications as prescribed. Clear written and verbal instructions describing exactly how each medication should be taken should be provided to each patient. Explaining the value of the medicines with their patient can help maximize benefits and minimize risks.
Communication can lessen the possibility of a harmful interaction between medicines and foods, beverages, and supplements. Communication can also help the patient recognize and avoid side effects as well as monitor the medicines’ effects. This is important because concerns about side effects can be barriers to medication regimen adherence, especially when the benefits of taking the medication are not well understood. To reduce potential concerns related to side effects, healthcare providers can provide information about common side effects when they prescribe medication. Helping patients build a foundation of knowledge is crucial to ensuring both initial and sustained adherence to medication regimens.
Overcoming the Challenge of Multiple Medications
For patients who take multiple medications, simplifying the medication regimen can greatly improve adherence. Increases in the frequency of doses are inversely related to adherence; with each additional daily dose, adherence decreases by 10%. Healthcare providers can try to simplify the medication by using similarly-timed doses and/or combination pills when available, and encourage patients who take multiple medications to place all doses for each day in a convenient pill box. Providers should minimize the use of different pharmacies and prescribers and varied refill dates, and encourage patients to consolidate medication refill visits to their pharmacy.
When affording medication is the problem
An often overlooked factor for healthcare providers is cost. Providers often feel rushed during their visits and sometimes are inadequately equipped to deal with patient-reported financial constraints. Patients often worry that raising issues of cost could possibly affect the quality of their future care. Healthcare providers should not hesitate to discuss the costs of treatment with their patients, or prescribe lower-cost generic alternatives when available. There are many programs that provide medications at low or no cost. NeedyMeds is an excellent source of information on these programs.
Pharmacists are important members of the healthcare team
Pharmacists also play a major role in improving adherence for their patients as a part of their healthcare team. Some pharmacies are able to deliver prescriptions, change your monthly refill to 90-day refills and synchronize refills for patients with multiple prescriptions, requiring fewer visits to the pharmacy. Pharmacists can also check to see if a less expensive generic medication is available if appropriate, or let you know if the drug may interact with any over-the-counter drugs or supplements you may be taking.
Talking Points for Healthcare Professionals
“You don’t know what your patients don’t know”
- Remember that your patients might have questions once they walk out the door.
- Reassure your patients that there are no silly questions.
- Insist that your patients read and follow the directions on the medicine label.
- Urge your patients to take a family member or friend to doctors’ appointments to take notes and ask questions.
- When your patients pick up their medications, encourage them to talk to the pharmacist if they have questions. It’s also a good idea for your patients to review all of their medications (even the one’s prescribed by other doctor’s) with the pharmacist.
Additional Resources for Healthcare Professionals: