Interventions for enhancing medication adherence

Haynes, R. Brian; Ackloo, Elizabeth; Sahota, Navdeep; McDonald, Helen; Yao, Xiaomei

doi:10.1002/14651858.cd000011.pub3

Cited by 802 publications

(618 citation statements)

References 363 publications

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“…MI is effective as a pretreatment adjunct and as an approach for less motivated or prepared patients, and may be applied for a wide range of medications across diverse populations. 11,44 Another communication technique that promotes patientcenteredness and helps guide medication-related discussions is a theory-based counseling model called the 5 A's. This model has been shown to be suitable for application in busy healthcare environments and does not require sophisticated skills or experience.…”

Section: Motivational Interviewing and Counselingmentioning

confidence: 99%

“…Several evidence reviews have identified interventions with modest effects in promoting both overall and condition-specific medication adherence. [11][12][13][14][15][16] Given the complex, multifactorial cause of medication non-adherence, interventions can be similarly multifactorial and multi-level. In this paper we focus on the physician-patient level to furnish providers with a guide to applying adherence research in the clinical encounter.…”

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confidence: 99%

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Recommendations for Providers on Person-Centered Approaches to Assess and Improve Medication Adherence

et al. 2016

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Medication non-adherence is a significant clinical challenge that adversely affects psychosocial factors, costs, and outcomes that are shared by patients, family members, providers, healthcare systems, payers, and society. Patient-centered care (i.e., involving patients and their families in planning their health care) is increasingly emphasized as a promising approach for improving medication adherence, but clinician education around what this might look like in a busy primary care environment is lacking. We use a case study to demonstrate key skills such as motivational interviewing, counseling, and shared decisionmaking for clinicians interested in providing patientcentered care in efforts to improve medication adherence. Such patient-centered approaches hold considerable promise for addressing the high rates of nonadherence to medications for chronic conditions. A dherence to medications is often suboptimal-up to 50 % of patients do not take their prescribed medication as recommended. 1-4 Medication non-adherence is associated with adverse health outcomes as well as negative social and economic consequences. [5][6][7] The problem of medication nonadherence is often multifaceted and multifactorial; in general, most conceptual models of medication non-adherence take an ecological perspective, and include patient factors (e.g., literacy, cognitive function), provider factors (e.g., complex regimens), social/community factors (e.g., access to providers and pharmacy), health care factors (e.g., interaction with healthcare system, trust, prior authorization, fragmentation), and policy implications (e.g., coverage of medication). 8-10 Thus, to be effective, interventions designed to improve appropriate medication use must adopt a comprehensive approach, often combining numerous proven strategies. Several evidence reviews have identified interventions with modest effects in promoting both overall and condition-specific medication adherence. [11][12][13][14][15][16] Given the complex, multifactorial cause of medication non-adherence, interventions can be similarly multifactorial and multi-level. In this paper we focus on the physician-patient level to furnish providers with a guide to applying adherence research in the clinical encounter.Evidence increasingly demonstrates that adopting a personcentered approach for medication use that incorporates patient beliefs, preferences, goals, and barriers to medication-taking (e.g., cost, technological ability, concerns about medication prescribing and use) leads to better clinical outcomes. 17,18 Clinicians are in a key position to elicit this information from patients and to incorporate it into medication-related decisions, thereby improving medication adherence rates. Person-centered care focuses on providing patients with greater choice, recognizing their roles as consumers of health care who know best their own beliefs and preferences. This care is meant to encourage value concordance-in this case, the match between the treatment that is selected and the treatment that i...

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Section: Motivational Interviewing and Counselingmentioning

confidence: 99%

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confidence: 99%

Recommendations for Providers on Person-Centered Approaches to Assess and Improve Medication Adherence

et al. 2016

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“…A recent systematic review of interventions to improve adherence to medicines prescribed for long-term treatments found that, while behaviour can be changed, effects were often small and short-lived. 9 The limited success of interventions has been attributed to deficits in both their development and design. 10 Interventions often have not been developed based on a theoretical model of adherence.…”

Section: Improving Adherencementioning

confidence: 99%

Improving adherence in urological conditions

Kenny¹

2017

Trends Urol & Men's Health

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“…However, the literature has been dominated by small-scale feasibility and exploratory studies and pilot evaluations that lack statistical power [26,29]. For patients with asthma, digital support services may provide a highly accessible and effective means of monitoring and improving adherence to treatment and disease control.…”

Section: Introductionmentioning

confidence: 99%