Estimates of adherence to long-term medication regimens range from 17% to 80%, and nonadherence (or nonpersistence) can lead to increased morbidity, mortality, and healthcare costs. Multifaceted interventions that target specific barriers to adherence are most effective, because they address the problems and reinforce positive behaviors. Providers must assess their patients' understanding of the illness and its treatment, communicate the benefits of the treatment, assess their patients' readiness to carry out the treatment plan, and discuss any barriers or obstacles to adherence that patients may have. A positive, supporting, and trusting relationship between patient and provider improves adherence. Individual patient factors also affect adherence. For example, conditions that impair cognition have a negative impact on adherence. Other factors--such as the lack of a support network, limited English proficiency, inability to obtain and pay for medications, or severe adverse effects or the fear of such effects--are all barriers to adherence. There are multiple reasons for nonadherence or nonpersistence; the solution needs to be tailored to the individual patient's needs. To have an impact on adherence, healthcare providers must understand the barriers to adherence and the methods or tools needed to overcome them. This report describes the barriers to medication adherence and persistence and interventions that have been used to address them; it also identifies interventions and compliance aids that practitioners and organizations can implement.

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The use of PDAs may increase the frequency and number of interventions documented by pharmacists; however, there is a lack of well-designed studies reporting the overall outcomes of using PDAs for intervention documentation by pharmacists.

Professional socialization is a process that must engage the entire organization for it to be optimally effective.1 While the curriculum focuses on technical competence and could cover subject matter such as ethics and professionalism in a formal, didactic manner, a 360-degree approach would consider all of the ways that we affect the professional development of our students, from admission through graduation and beyond. Thus, professionalism is both a curricular and an extracurricular concern.The purpose of this paper is to describe how one organization is changing its culture by examining ways to influence professional socialization throughout a student's and faculty member's entire academic experience in a school of pharmacy. While the focus is on students, transformation of faculty members is also essential. Students will flounder without appropriate role models. Therefore, some examples also address the professional socialization of the faculty. Specific programs and changes that have been implemented are described. In addition, efforts to assess the impact of the changes are reported.

Learning never ceases. While continuing education is important for all of us, we are not speaking of licensure requirements. We are speaking of learning within your health system that systematically incorporates knowledge gained through research and clinical care into individual care.