Improving Medication Adherence

 

Keep a watch…on the faults of the patients, which often make them lie about the taking of things prescribed. For through not taking disagreeable drinks, purgative or other, they sometimes die.

Hippocrates, Decorum

 

Doctors ask: Why do patients not take their medicine as prescribed? Maybe patients are asking: What are healthcare providers doing to support medication adherence? Years back, I was a patient who needed to take just a single tablet of bromocriptine everyday. I didn’t remember to take it every night! I was in my final year of residency when I diagnosed myself as having a prolactinoma and needed to take medication. But even before that, when this condition began manifesting as menstrual irregularities, my gynecologist prescribed oral contraceptive pills. I also often forgot to take them! Until I finally decided I didn’t want to continue taking these pills. My menses stopped completely for almost a year – and that’s how I realized I had a pituitary problem. Yes, doctors who become patients are not adhering better to medication.

A few months back, I gave a presentation on tools to improve adherence to diabetes treatment. I focused on apps. I became even more aware that more work is needed in this area.

 

 

The World Health Organization defines adherence as –

the extent to which a person’s behavior – taking medication, following a diet, and/or executing lifestyle changes, corresponds with agreed recommendations from a healthcare provider.

 

Is it mere forgetfulness? Check out the full WHO document here. According to the WHO, adherence is a multidimensional phenomenon with five aspects. It is important to note that patient-related factors is only one aspect. In the Philippines, socioeconomic factors are definitely important. I trained in a government hospital. I witnessed first-hand how patients were not taking medications, not because they didn’t understand the doctor’s instructions but because they weren’t even able to afford buying them. It still happens in my private practice.

 

 

Join me again at #HealthXPh tweet chat on Saturday, 1 November 2014 9 pm Manila time as we discuss the following:

T1 What aspects are not addressed by current strategies to improve medication adherence?

T2 What are strategies to improve medication adherence that do not require new technology?

T3 As a healthcare provider or patient, do you recommend or use medication reminder apps?

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