Assessing medication adherence: options to consider

Lehmann, Audrey; Aslani, Parisa; Ahmed, Riaz; Celio, Jennifer; Gauchet, Aurélie; Bedouch, Pierrick; Bugnon, Olivier; Allenet, Benoît; Schneider, Marie‐Paule

doi:10.1007/s11096-013-9865-x

Cited by 256 publications

(260 citation statements)

References 104 publications

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“…They believe this is just the beginning of methodological development [7]. While there are several wellestablished methods to assess adherence, none of them fulfill high-quality scientific and clinical requirements [8]. Moreover, methodological impediments have emerged; for instance, self-reported questionnaires -the cheapest and the easiest way to measure the adherence level, have over-or under-estimated this phenomenon [9,10].…”

Section: Treatment Adherence: Methodological Issues and Definitionmentioning

confidence: 99%

Medication adherence in patients after percutaneous coronary intervention due to acute myocardial infarction: From research to clinical implications

Świeczkowski

Mogielnicki²,

Cwalina

et al. 2013

Cardiol J

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Section: Treatment Adherence: Methodological Issues and Definitionmentioning

confidence: 99%

Medication adherence in patients after percutaneous coronary intervention due to acute myocardial infarction: From research to clinical implications

Świeczkowski

Mogielnicki²,

Cwalina

et al. 2013

Cardiol J

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“…Physicians can indeed be considered the experts in medicine and patients the experts in their own lives. 33 Assessing drug adherence in primary care settings in a nonthreatening way 3 and recognizing the challenges of taking medications regularly 34 may help facilitate patient-physician discussion about medications 35,36 and about patient knowledge and beliefs. 33 Another way to bridge the gap between patients and physicians could be to encourage collaboration between all health professionals involved in ambulatory care.…”

Section: Discussionmentioning

confidence: 99%

Discordance Between Drug Adherence as Reported by Patients and Drug Importance as Assessed by Physicians

Sidorkiewicz

Tran

Cousyn

et al. 2016

The Annals of Family Medicine

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PURPOSE Among patients on long-term medical therapy, we compared (1) patient and physician assessments of drug adherence and of drug importance and (2) drug adherence reported by patients with drug importance as assessed by their physicians.METHODS We recruited to the study patients receiving at least 1 long-term drug treatment from both hospital and ambulatory settings in France. We compared drug adherence reported by patients and drug importance assessed by physicians using Spearman correlation coefficients. Reasons for nonadherence were collected with open-ended questions and classified as intentional or unintentional.RESULTS Between April and August 2014, we recruited 128 patients taking 498 drugs. Patients and physicians showed only weak agreement in their assessments of drug adherence (r = -0.25; 95% CI, -0.37 to -0.11) and drug importance (r = 0.07; 95% CI, 0.00 to 0.13). We did not find any correlation between physician-assessed drug importance and patient-reported drug adherence (r = -0.04; 95% CI, -0.14 to 0.06). In all, 94 (18.9%) of the drugs that physicians considered important were not correctly taken by patients. Patients intentionally did not adhere to 26 (48.1%) of the drugs for which they reported reasons for nonadherence. CONCLUSIONSWe found substantial discordance between patient and physician evaluations of drug adherence and drug importance. Nearly 20% of drugs considered important by physicians were not correctly taken by patients. These findings highlight the need for better patient-physician collaboration in drug treatment. 2016;14:415-421. doi: 10.1370/afm.1965. INTRODUCTION N onadherence, defined as the extent to which a person's behavior fails to coincide with medical advice, may lead to negative outcomes and long-term mortality, 1,2 especially among patients with chronic conditions and on complex medication regimens. 3,4 Approximately 50% of patients stop taking their medications 6 months after drug initiation. 3,5 Reasons for nonadherence go beyond simple forgetfulness. Patients' perceptions and beliefs are crucial in their medication-taking behaviors. 6 Two types of drug nonadherence are usually distinguished: intentional and unintentional. 4,7 Intentional nonadherence is an active decision by patients who decide not to take medications as prescribed because of beliefs, 8 perceived need or benefit, 9 side effects, or burden of treatment. Unintentional nonadherence is a passive process whereby patients fail to adhere to treatments because of circumstances beyond their control. Ann Fam Med 7Individual adherence to the different drugs a patient takes can therefore vary considerably, 10,11 with various consequences depending on the drug or disease of interest. 12Not all drugs patients take have the same impact on their health outcomes: some are intended to prevent complications, others to reduce symptoms. Physicians and patients may differentially balance the need for each drug, which can result in a discordance in their priorities. 416In this study, we aimed to investigate...

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“…In the absence of sophisticated methods for assessing nonadherence in daily clinical practice, such as electronic monitoring, it is advisable to combine all the information from available sources, such as self-reports, collateral reports, pharmacy refill data and/or assays, 80,81 to determine at each clinical encounter whether patients are experiencing issues with nonadherence. 12 Once patients at risk of medication nonadherence are identified, they can be targeted for more intensive, tailored interventions.…”

Section: Strategies For Managing Nonadherencementioning

confidence: 99%

Practical Recommendations for Long-term Management of Modifiable Risks in Kidney and Liver Transplant Recipients

et al. 2017

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Short-term patient and graft outcomes continue to improve after kidney and liver transplantation, with 1-year survival rates over 80%; however, improving longer-term outcomes remains a challenge. Improving the function of grafts and health of recipients would not only enhance quality and length of life, but would also reduce the need for retransplantation, and thus increase the number of organs available for transplant. The clinical transplant community needs to identify and manage those patient modifiable factors, to decrease the risk of graft failure, and improve longer-term outcomes. COMMIT was formed in 2015 and is composed of 20 leading kidney and liver transplant specialists from 9 countries across Europe. The group's remit is to provide expert guidance for the long-term management of kidney and liver transplant patients, with the aim of improving outcomes by minimizing modifiable risks associated with poor graft and patient survival posttransplant. The objective of this supplement is to provide specific, practical recommendations, through the discussion of current evidence and best practice, for the management of modifiable risks in those kidney and liver transplant patients who have survived the first postoperative year. In addition, the provision of a checklist increases the clinical utility and accessibility of these recommendations, by offering a systematic and efficient way to implement screening and monitoring of modifiable risks in the clinical setting. 12 Department of Gastroenterology and Hepatology, Erasmus MC, University Hospital Rotterdam, the Netherlands. 13 Department of Gastroenterology and Hepatology, University Hospitals KU Leuven, Belgium.14 Abdominal Transplant Surgery, Microbiology and Immunology Department, University Hospitals KU Leuven, Belgium. 15 Department of Hepatology and Liver Transplantation, Reina Sofía University Hospital, IMIBIC, CIBERehd, Spain. www.transplantjournal.com S1 S olid organ transplantation has evolved from an experimental procedure to an established treatment option for many types of end-stage organ failure. Both patient and graft outcomes are continuing to improve, and 1-year patient and graft survival currently exceed 80%.1,2 However, survival rates gradually decline over the long term. In kidney transplant, 5-and 10-year graft survival rates in Europe are 77% and 56%, and for liver transplant, 64% and 54% (Figures 1 and 2). 3,4 Although most European countries have seen an increase in both living and deceased donation, transplantation is not available to all who would benefit from the procedure, and there is considerable morbidity and mortality for those listed for transplant.6 Therefore, maximizing long-term graft survival and reducing the need for retransplantation is paramount, not only in improving outcomes for the recipients but also for those awaiting a graft. The improvement in outcomes is predominantly due to reduction in (Transplantation. 2017;101:S1-S41). The authors were approached by Astellas to discuss the practical implementation o...

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Assessing medication adherence: options to consider

Cited by 256 publications

References 104 publications

Medication adherence in patients after percutaneous coronary intervention due to acute myocardial infarction: From research to clinical implications

Medication adherence in patients after percutaneous coronary intervention due to acute myocardial infarction: From research to clinical implications

Discordance Between Drug Adherence as Reported by Patients and Drug Importance as Assessed by Physicians

Practical Recommendations for Long-term Management of Modifiable Risks in Kidney and Liver Transplant Recipients

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