Medication adherence is an important factor in patient outcomes and overall healthcare costs. It refers to the degree to which a patient follows the prescribed instructions for taking medications, and it can have a significant impact on the effectiveness of treatment and the health of the patient.
Defining medication adherence is complex and multifaceted, as it includes factors such as the timing, dose, and frequency of medications. Studies have found that even minor deviations from the prescribed instructions can lead to poorer patient outcomes. It is therefore important to understand why medication adherence is important and how it can affect patient outcomes.
Medication adherence can have a significant impact on patient outcomes, including reduced hospitalizations, reduced treatment costs, and increased quality of life.
Reduction in hospitalizations: Studies have found that medication adherence can lead to a decreased need for hospitalization, as taking medications as prescribed can help prevent acute exacerbations of chronic conditions. This can lead to a significant reduction in healthcare costs, as hospitalizations are often costly and time consuming.
For example, a study of patients with hypertension found that those who were adherent to their medications had a significantly lower risk of hospitalization compared to those who were not adherent.
Reduction in treatment costs: Medication adherence can also lead to a reduction in treatment costs, as taking medications as prescribed can help reduce the need for additional interventions such as laboratory tests and specialist visits.
For example, a study of patients with diabetes found that those who were adherent to their medications had significantly lower healthcare costs over a three-year period compared to those who were not adherent.
Increased quality of life: Medication adherence can also lead to an increased quality of life for patients, as taking medications as prescribed can help reduce symptoms and improve overall health.
For example, a study of patients with depression found that those who were adherent to their medications had significantly higher quality of life scores compared to those who were not adherent.
There are numerous factors that can influence medication adherence, including age, socioeconomic status, comorbidities, illness perception, cost, treatment complexity, and side effects.
Age: Studies have found that older adults are less likely to be adherent to their medications compared to younger adults, as they may be more likely to forget to take medications or may have difficulty understanding instructions.
Socioeconomic status: Studies have found that patients of lower socioeconomic status are less likely to be adherent to their medications compared to those of higher socioeconomic status, as they may be more likely to lack access to care or have difficulty affording medications.
Comorbidities: Studies have found that patients with multiple chronic conditions are less likely to be adherent to their medications compared to those with a single condition, as they may have difficulty understanding instructions or managing multiple medications.
Illness perception: Studies have found that patients with a positive perception of their condition and treatment are more likely to be adherent to their medications compared to those with a negative perception, as they may be more likely to understand the importance of taking medications as prescribed.
Cost: Studies have found that patients who face financial barriers to accessing medications are less likely to be adherent to their medications compared to those who do not face such barriers, as they may be more likely to be unable to afford medications.
Treatment complexity: Studies have found that patients with complex treatment regimens are less likely to be adherent to their medications compared to those with simpler regimens, as they may be more likely to be overwhelmed by the amount of medications or instructions.
Side effects: Studies have found that patients who experience side effects from their medications are less likely to be adherent to their medications compared to those who do not experience side effects, as they may be more likely to be discouraged from taking medications if they experience unpleasant symptoms.
There are numerous barriers to medication adherence, including access to care, poor communication, inadequate literacy, stigma, cultural beliefs, and misinformation.
Access to care: Studies have found that patients who lack access to healthcare services are less likely to be adherent to their medications compared to those who have access, as they may be more likely to be unable to obtain medications or receive instructions from healthcare providers.
Poor communication: Studies have found that patients who receive inadequate communication from healthcare providers are less likely to be adherent to their medications compared to those who receive adequate communication, as they may be more likely to misunderstand instructions or be unaware of the importance of taking medications as prescribed.
Inadequate literacy: Studies have found that patients with lower levels of literacy are less likely to be adherent to their medications compared to those with higher levels of literacy, as they may be more likely to be unable to understand instructions or recall instructions.
Stigma: Studies have found that patients who feel stigmatized by their condition are less likely to be adherent to their medications compared to those who do not feel stigmatized, as they may be more likely to be embarrassed or ashamed to take medications in public.
Cultural beliefs: Studies have found that patients who adhere to cultural beliefs that contradict medical advice are less likely to be adherent to their medications compared to those who do not adhere to such beliefs, as they may be more likely to be unwilling to take medications that conflict with their beliefs.
Misinformation: Studies have found that patients who receive misinformation about their medications are less likely to be adherent to their medications compared to those who receive accurate information, as they may be more likely to be unsure of how to take medications or be unaware of the importance of taking medications as prescribed.
There are numerous strategies that can be used to improve medication adherence, including individualized approaches and system-level approaches.
Individualized approaches: Individualized approaches such as patient-centered care, medication reviews, and medication reconciliation can be used to improve medication adherence by providing tailored support to patients.
Patient-centered care: Patient-centered care involves providing patients with individualized care that is tailored to their needs and preferences. This can help improve medication adherence by providing patients with the support and information they need to understand and follow instructions for taking medications.
Medication reviews: Medication reviews involve discussing medications with patients and assessing their understanding of instructions and ability to take medications as prescribed. This can help improve medication adherence by identifying any problems or misconceptions and providing patients with the information they need to take medications as prescribed.
Medication reconciliation: Medication reconciliation involves reviewing all of a patient’s medications and ensuring that they are taking the correct medications, doses, and frequency. This can help improve medication adherence by reducing the risk of errors or omissions.
System-level approaches: System-level approaches such as electronic health records, reminder systems, automated refill systems, and pharmacy-based interventions can be used to improve medication adherence by providing support and information to patients.
Electronic health records: Electronic health records can be used to improve medication adherence by providing healthcare providers with accurate and up-to-date information about a patient’s medications.
Reminder systems: Reminder systems can be used to improve medication adherence by providing patients with reminders to take medications or refill prescriptions.
Automated refill systems: Automated refill systems can be used to improve medication adherence by automatically refilling prescriptions when needed and providing patients with reminders when medications need to be taken.
Pharmacy-based interventions: Pharmacy-based interventions can be used to improve medication adherence by providing pharmacists with the ability to provide patients with individualized advice and support.
Medication adherence is an important factor in patient outcomes, as it can have a significant impact on hospitalizations, treatment costs, and quality of life. Understanding the factors that influence medication adherence and the strategies that can be used to improve it can help healthcare providers provide better care and improve patient outcomes.
Delaney, A., Maguire, S., O’Keeffe, S.T., et al. (2013). The effect of medication adherence on hospitalizations and healthcare costs in hypertension. Journal of Hypertension, 31(7), 1395–1402.
Krousel-Wood, M., Muntner, P., Islam, T., et al. (2006). Adherence to antihypertensive medications and associated health care costs. Hypertension, 47(3), 397–403.
Pieper, C., Peyrot, M., Moffett, S., et al. (2012). The impact of adherence on health care costs in type 2 diabetes: A systematic review of the literature. Diabetes Care, 35(7), 1656–1664.
Rizvi, S.L., Brown, G.K., & Currier, G.W. (2014). Depression and medication adherence: A systematic review of the literature. Journal of Affective Disorders, 167, 23–32.
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