Increasing Adherence & Minimizing Risk of Medication Abandonment: Pharmacists overcome barriers

Many factors can contribute to a patient not taking their medication. A patient not taking their medication is often referred to as a patient being non adherent or non compliant. The problem with these terms and the misconceptions that accompany these terms is that it infers or implies fault or blame upon the patient. This is part of the problem and does not help. Jumping to judgements is easy and what actually can be difficult is breaking things down and getting to the real issue is often hard.

It is also referred to as medication abandonment as the patient is making the choice to abandon their medication regimen. Why would one choose to not take their medication? Failing to see the benefit? Cost or financial hardships? Maybe it is not a choice at all. Maybe it is the difficulty of a regimen or timing. Maybe consistency or remembering to take the medication is a problem.

Identifying and recognizing the underlying issue is the first step.

While some factors preventing adherence can be altered or changed it is important that some cannot and then the best approach is to minimize where you can. Sometimes the key is coordinating the right healthcare professional and resources to help a patient work through these common barriers.

Patients may be cautious or untrusting until trust is built

While patients want to know their providers and overall healthcare team is smart and has answers as well as the ability to make them feel better. It is equally important that a patient knows and feels that you care. Due to the large amount of miss information or miss conceptions of healthcare, it is important that healthcare providers first earn a patient's trust. The patient and healthcare team relationship is extremely important.

Patients may have miss-understandings or miss-perceptions.

Addressing this lack of knowledge or limited information can be addressed with essential patient education. It is often said that knowledge is power. There is so much miss-information floating around the internet and many self-proclaimed experts out there that often direct patients into not understanding or knowing the importance of certain therapies. Due to this patients may choose not to start or continue therapy. Pharmacists and nurses can help teach and give education as well as help patients sift through the abundance of information that is available. Pharmacists know medications well. They can help patients to know how medications work, why they are important and potential side effects.

Pharmacists play a critical role in helping patients understand their medications and how to take them correctly. We are experts in drug interactions, side effects, and dosing schedules. When patients have questions about their medications or concerns about side effects, we are often the first point of contact they turn to for guidance.

This knowledge is essential for patients to know and help them decide if they want to continue treatment.

Motivation:

Life can be demanding. One's time and efforts are often spread thin among many obligations such as family or work priorities. Often these life demands can lead to mental health struggles such as anxiety or depression. The feeling of being helpless and burned out in these demands can often leave one unmotivated for other demand such as self health. Therapists (Social Workers, Psychologists and Psychiatrists) are key to help patients work through some of these struggles utilizing therapies such as Cognitive Behavioral Therapy (CBT) or Health and Behavior Assessment and Intervention (HBAI) Services.

Memory:

As good as our memories can be, forgetfulness can happen with all of us. Some medication regimens make it difficult for any of us to be compliant. It is important to establish a regimen or schedule to help remember to take ones medications consistently. This becomes even more important for our elderly. If family or caregivers are available this may help. Education and support for caregivers also becomes an important task.

Pharmacists can help patients set up medication boxes and other tools to help one remember to take their medication. Pharmacists can also help patients set up reminders and create a routine for taking their medications, which can be especially helpful for patients who are managing multiple prescriptions.

One of the most effective ways that pharmacists can help patients overcome medication abandonment is by using medication synchronization programs. These programs allow patients to pick up all of their medications at once, on a regular schedule. This can be especially helpful for patients who are managing multiple prescriptions or who have difficulty remembering to refill their medications on time.

Pharmacists can also use technology to support patients' adherence to their medications. For example, we can use text messages or phone calls to remind patients when it's time to take their medications. Pharmacists can help with medication deliveries.

We can also use electronic health records to track patients' medication histories and identify potential issues with adherence.

Cost:

As we all are facing the challenges of inflation and potentially a recession. Insurance formularies often lag behind Medical Guidelines. The barrier of insurance not paying for a needed medication is real. Often more efficacious medications are ideal yet a patient's insurance does not cover it. Or even if the medications are on formulary, depending on how many medications one has to take and the cost of each copay, the copays stack up and accumulate fast. Cost is an ever increasing problem.

It is not uncommon for patients to face the difficult task of paying for medications or paying for food. The increased demands of cost of living have made things extremely difficult for patient's ability to afford medications.

In addition to providing education and counseling, pharmacists can also help patients overcome barriers to adherence. For example, we can work with insurance companies to find lower-cost alternatives to expensive medications. Pharmacists are key in helping to determine if medications can be changed to a lower cost medication that may bring similar benefit. Pharmacists can also be help point patients towards helpful coupons and patient assistant programs that may help.

Medication abandonment is a serious problem that can have significant consequences for patients' health outcomes. It can lead to the worsening of chronic conditions, the development of drug-resistant infections, and even hospitalizations or emergency room visits. As pharmacists, we are the best resource and a key part of the solution to help patients overcome this issue. By providing education, counseling, and support, we can help patients understand their medications and how to take them correctly. Through medication synchronization programs and the use of technology, we can also help patients overcome barriers to adherence and stay on track with their medications. Pharmacists are key to a patient's medication success.

**Please take note, my views are my own and are not associated or representative of my employer(s). This website and its associated platforms are for education purposes only and not medical advice. (If one wants to establish a relationship in which individual circumstances can be evaluated please send a message)