Tips to Help Minimize Medication Nonadherence in Your Patients
Abstract
Past research suggests the overall nonadherence rates for antidepressants range from 13 percent (at the outset of prescription) to 55.7 percent.
In our world of ever-expanding pharmacologic options, we continue to see patients whose treatment may be compromised by nonadherence to our prescribed medication regimens.
By some estimates, the overall nonadherence rates for antidepressants range from 13 percent (at the outset of prescription) to 55.7 percent (1).
There are a number of factors that may contribute to differential levels of risk of nonadherence:
Duration of recommended therapy
Patient age
Cost of the medication
Reason for the use of the medication (treatment of a condition versus prevention) (2)
Complexity of the treatment regimen/frequency of dosing
Severity of the condition being treated
Patients often leave the office with an incomplete understanding or misunderstanding of the rationale for the use of the medication as well as of the instructions. One study found that 60 percent of patients who were interviewed immediately following their appointment misunderstood the directions for taking the medication (3).
Also, because patients generally want to please their health care providers, they may hold back on reporting problems they experience on prescribed medications, such as side effects, lack of efficacy, or high costs, or in disclosing that they have reduced or stopped the medication.
So what can clinicians do to help minimize this problem?
A good starting point is to provide the patient with a clear, non-jargon explanation of the specific improvement that is expected as a result of the use of the medication, as well as an explanation of the side effects that could be experienced by the patient.
When prescribing new medications, offer your patient clearly written instructions on how to take the medication, as well as benefits and potential side effects they might experience.
It is also helpful to let the patient know that there are other options available if the recommended treatment doesn’t work, is not well tolerated, or is not affordable.
Many electronic health record systems that include electronic prescribing functionality allow clinicians to easily review a patient’s prescription history and some allow the clinician to obtain actual prescription-fill data that can allow the clinician to monitor the patient’s use of the medication.
Working collaboratively with patients to treat their conditions and meet their health goals is an approach that can help to reduce the problem of medication nonadherence (4). ■
1. Sansone R and Sansone L. Antidepressant Adherence: Are Patients Taking Their Medications?Innov Clin Neurosci. 2012;9(5-6):41-46.
2. Alekhya P, Sriharsha M, Priya Darsini T, et al. Treatment and Disease Related Factors Affecting Nonadherence Among Patients on Long Term Therapy of Antidepressants. J Depress Anxiety. 4:175.
3. Kessels R. Patients' Memory for Medical Information. J R Soc Med. 2003;96(5):219-22.
4. Chapman S and Horne R. Medication Nonadherence and Psychiatry. Current Opinion in Psychiatry. 2013;26(5):446-452.
