Strategies for Improving Medication Adherence

Assess Patient Understanding and Behavior  What we need to know and understand is: How do patients feel about having to take the medication? How do patients feel about having to take the medication? What do they think will happen to their health if they don’t take the medication as prescribed? What do they think will happen to their health if they don’t take the medication as prescribed?

Assessing Understanding of Medication Purpose: Use of Open- Ended Questions What did your doctor tell you about this medicine? What did your doctor tell you about this medicine? What exactly is your medicine supposed to do? What exactly is your medicine supposed to do? What problem has caused you to need this medicine? What problem has caused you to need this medicine?

Assessing Future Behavior  Using open-ended questions we can learn about our patient’s medication taking behaviors: When do you plan to take your medication? When do you plan to take your medication? How long are you going to be taking your medication? How long are you going to be taking your medication? What did your doctor tell you to do if you missed a dose? What did your doctor tell you to do if you missed a dose? How should you be storing this medication? How should you be storing this medication?

Assessing Past Behavior  This kind of probing can also help us understand past behavior: How have you been taking this medication? How have you been taking this medication? How has taking this medication changed your daily schedule, habits, etc.? How has taking this medication changed your daily schedule, habits, etc.? How many doses of this medication have you missed in the last week? How many doses of this medication have you missed in the last week? What caused you to miss these doses? What caused you to miss these doses?

Assessing Medication Effectiveness How do you know if your cholesterol / blood pressure medication is working? How do you know if your cholesterol / blood pressure medication is working? How often do you get your blood pressure checked? How often do you get your blood pressure checked? What was your last TC reading? What was your last TC reading?

Assessing Potential Medication Problems What kinds of problems are you having? What kinds of problems are you having? What side effects have you noted since you started taking this medication? What side effects have you noted since you started taking this medication? What side effects are you supposed to look for? What side effects are you supposed to look for?

False Assumptions about Patient Understanding and Medication Adherence  Don’t assume that: doctors have talked to their patients. doctors have talked to their patients. patients understand all the information you give them. patients understand all the information you give them. if the patient understands, they will just take the medication as required. if the patient understands, they will just take the medication as required. because someone does not take the medication as directed that they don’t care or aren’t motivated. because someone does not take the medication as directed that they don’t care or aren’t motivated. just because someone takes their medication correctly now, they will continue to do so. just because someone takes their medication correctly now, they will continue to do so. doctors monitor patient compliance. doctors monitor patient compliance. patients who are having problems will ask you for help. patients who are having problems will ask you for help.

Techniques to improve patient understanding Examine your own attitude toward patient counseling. Examine your own attitude toward patient counseling. Emphasize key points. Emphasize key points. Give reasons why something is important (antibiotics). Give reasons why something is important (antibiotics). Give concrete instructions. Give concrete instructions. Present key information at the beginning and the end of your discussions. Present key information at the beginning and the end of your discussions. Use written information to back up your verbal counseling. Use written information to back up your verbal counseling. Verify what patients have learned. Verify what patients have learned.

Techniques to Improve Patient Behavior Teach them to integrate new behaviors with current behaviors. Teach them to integrate new behaviors with current behaviors. Provide good aids when you can, like pill organizers, counter caps, alarms etc. Provide good aids when you can, like pill organizers, counter caps, alarms etc. Help patients with self monitoring options, log books, calendars, etc. Help patients with self monitoring options, log books, calendars, etc. Monitor medication use on your end –refill records – and encourage patients where appropriate. Monitor medication use on your end –refill records – and encourage patients where appropriate. Refer patients with extreme or special needs to appropriate help – Medicaid, various medication assistance programs, reading comprehension services, and so on. Refer patients with extreme or special needs to appropriate help – Medicaid, various medication assistance programs, reading comprehension services, and so on.