Adherence: a review of education, research, practice and policy in Spain

Abstract

Aims:To describe medication adherence education, practice, research and policy efforts carried out by pharmacists in Spain in the last decade.Methods:A literature review using Medline and Embase was conducted covering the last ten years. Additional pharmaceutical bibliographic sources in Spain were consulted to retrieve articles of interest from the last decade. Articles were included if a pharmacist was involved and if medication adherence was measured or there was any direct or indirect pharmacist intervention in monitoring and/or improving adherence. Articles focusing on the development of tools for adherence assessment were collected. Pre- and post-graduate pharmacy training programs were also reviewed through the Spanish Ministry of Education and Science website. Information regarding policy issues was gathered from the Spanish and Autonomous Communities of Education and Health Ministries websites.Results:Pharmacists receive no specific training focused on adherence. There is no specific government policies for pharmacists in Spain related to medication adherence regardless of their practice setting. A total of 24 research studies met our inclusion criteria. Of these, 10 involved pharmacist intervention in monitoring and/or improving adherence and 14 assessed only adherence. Ten studies involved hospital pharmacists working in collaboration with another healthcare professional.Conclusions:At present in Spain, the investigative role of the pharmacist is not well developed in the area of medication adherence. Adherence improvement services provided to patients by pharmacists are not implemented in a systematic way. However, recent efforts to implement new initiatives in this area may provide the basis for offering new cognitive services aimed at improving patient adherence in the near future.

Women and men report different behaviours in, and reasons for medication non-adherence: a nationwide Swedish survey

“…However, it appears that pharmacy schools in many countries provide insufficient education on the subject54,55, and it is generally believed that pharmacists in the community setting do not focus on it enough 561,57, and are in the unique position of being the last contact with the patient before they start their medication 54. They are thus well positioned to address NA and to play a key role in providing counselling about medication and subsequently improving adherence 58.…”

Impacto do perfil clínico e sociodemográfico na adesão ao tratamento de pacientes de um Centro de Atenção Psicossocial a Usuários de Álcool e Drogas (CAPSad)

“…Tal ocorrência é altamente prejudicial às políticas direcionadas aos usuários de álcool e outras drogas, uma vez que a eficácia de qualquer tratamento depende estreitamente da adesão do paciente 10,11 . Segundo Fikri-Benbrahim et al 12 , a não adesão é um fenômeno que constitui um grande problema para o tratamento, especialmente de doenças crônicas. Leite e Vasconcellos 13 afirmam que o sucesso da terapia -a cura, controle ou prevenção de uma patologia -depende da adesão ao tratamento.…”

Assessing the adherence to and the therapeutic effectiveness of hypolipidemic agents in a population of patients in Brazil: a retrospective cohort study

“…Non-adherence to drug therapy is a principal cause of treatment failure11 and is considered a high priority public health issue 12…”

“…Direct methods are designed to detect the therapeutic drug or its metabolites in the patients’ biological fluids. On other hand, indirect methods mainly include interviews, pill counting, medication electronic monitoring systems and Medication Possession Ratio (MPR) evaluation 11,15. MPR considers the amount of times the patient takes out medicines from the health service pharmacy.…”