Medication adherence: a review of pharmacy education, research, practice and policy in Finland

Bell, J. Simon; Enlund, Hannes; Vainio, Kirsti

doi:10.4321/s1886-36552010000300001

Cited by 7 publications

(12 citation statements)

References 59 publications

(138 reference statements)

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“…An understanding of the role of gender in this respect is also valuable, since gender appears to influence both NA itself and the reasons for NA. The focus of the education and counselling is thus important for the improvement of adherence; it should focus on obstacles to adherence and, according to our study, probably not as much on the cost of the medications as previous studies have shown 59. It is also crucial to distinguish between intentional and unintentional NA when offering individualised counselling 60.…”

Section: Discussionmentioning

confidence: 77%

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

Sundbom

Bingefors

2012

Pharmacy Practice (Internet)

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ObjectiveThe aim of the present study was to analyse gender differences in self-reported non-adherence (NA) to prescribed medication in the Swedish general population. We aimed to study unintentional and intentional NA as well as the reasons given for NA.MethodsA questionnaire was mailed to a cross-sectional, random, national sample of people aged 18-84 years in Sweden (n=7985). The response rate was 61.1% (n=4875). The questionnaire covered use of prescription drugs, NA behaviour and reasons for NA.ResultsUse of prescription drugs was reported by 59.5% (n=2802) of the participants, and 66.4% (n=1860) of these participants did not adhere to the prescribed regimen. No overall gender differences in reporting NA were found. However, when analysing the various types of NA behaviour and the reasons for NA, different gender patterns emerged. Men were more likely to report forgetting [OR=0.77 (95%CI 0.65:0.92)], changing the dosage [OR=0.64 (95%CI 0.52:0.79)] and that they had recovered [14.3%, (OR=0.71 (95%CI 0.56:0.90)] as a reason. In contrast, more women than men reported filling the prescription but not taking the drug [OR=1.25 (95%CI 1.02:1.54)] and reported the development of adverse drug reactions (ADRs) [OR=1.89 (95%CI 1.37:2.59)] as a reason more commonly. The gender differences remained, in most cases, after controlling for confounders such as age, socioeconomic factors, medical problems and attitudes toward drugs.ConclusionsWomen and men have different patterns of NA behaviour and different reasons for NA. Therefore, if adherence is to be improved, a wide knowledge of all the reasons for NA is required, along with an understanding of the impact of gender on the outcomes.

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Section: Discussionmentioning

confidence: 77%

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

Sundbom

Bingefors

2012

Pharmacy Practice (Internet)

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“…Adherence research and education have focused on understanding and addressing the contextual factors that contributes to medication non-adherence 27. Demographic characteristics may help to identify patients who are at risk for non-adherence 28.…”

Section: Introductionmentioning

confidence: 99%

Medication adherence among ambulatory patients with type 2 diabetes in a tertiary healthcare setting in Southwestern Nigeria

Adisa

Fakeye

Fasanmade

2011

Pharmacy Practice (Internet)

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Adisa R, Fakeye TO, Fasanmade A. Medication adherence among ambulatory patients with type 2 diabetes in a tertiary healthcare setting in southwestern Nigeria. Pharmacy Practice (Internet) 2011 Apr-Jun;9(2):72-81.www.pharmacypractice.org (ISSN: 1886-3655) 72 ABSTRACT * Objective: To assess adherence to medication among ambulatory patients with type 2 diabetes, ascertain the level of glycemic control, and evaluate patients' opinions on probable reasons for nonadherence with a view to identify areas of intervention to improve adherence. Methods: A prospective cross-sectional study was carried out at a 900-bed tertiary teaching hospital in Ibadan, Southwestern Nigeria between June and August, 2009. Out of 140 consented patients, 114 (81.4%) properly responded to the validated and pre-tested data collection tool and these were subsequently considered for analysis. Descriptive statistics were used to summarize the data. Means and proportions were compared using student t-test and chi-square or Kruskal-Wallis test as appropriate, with p<0.05 considered statistical significant.Results: Approximately sixty percent of the patients were adjudged adherent with prescribed medication. Out of 58.8% of the cohort who gave their recent fasting plasma glucose (FPG) values, 59.7% had FPG above 110mg/dL. The mean FPG for patients was 139.05 (SD=70.5)mg/dL, males and females significantly differed in their mean FPG, 146.55 (SD=85.0)mg/dL versus 133.33 (SD=57.6)mg/dL respectively (p=0.032). Also, the mean FPG values for adherent patients, 137.09 (SD=59.3)mg/dL was lower than their non-adherent counterparts, 143.92 (SD=87.6) mg/dL, but the difference was not statistically significant (p=0.095). Financial constraint (34.4%) was the major barrier to optimal adherence with medication. A significant association exist between genders and opinions on physician's mode of approach during patientphysician interaction as a contributory factor for non-adherence (p=0.038). Conclusion: Medication adherence of ambulatory type 2 diabetes patients is considerable. However, the relatively high level of adherence did not appear to have significantly impacted on patients' glycemic status due to a substantial number who had plasma glucose above the recommended targets. Multiple methods may be required to detect patient who report adherence but who may in fact be nonadherent. Also, adherence to other aspects of diabetes management plan needs to be encouraged in order to accomplish optimal glycemic control. Initiatives targeting patient-specific intervention to improve medication adherence should be considered.Keywords: Medication adherence. Diabetes Mellitus. Nigeria. ADHERENCIA A LA MEDICACIÓN ENTRE PACIENTES CON DIABETES TIPO 2 EN ESTABLECIMIENTOS SANITARIOS TERCIARIOS EN EL SUROESTE DE NIGERIA RESUMENObjetivo: Evaluar la adherencia a la medicación entre pacientes ambulatorios con diabetes tipo 2, determinar el nivel de control glucémico, y evaluar las opiniones de los pacientes sobre las probables razones de la no adherencia con vista a identificar ...

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“…The results shows that patient counseling is done in all of the hospitals of the Karachi city where survey was conducted, all 30 (100 %) samples provide patient counseling services. Patients should be informed about the need and importance of patient counseling from their perspective and it is very necessary to ensure effective disease management and drug therapy 8 . Pharmacist's involvement in patient care has shown reduced number of hospital admissions and emergency department visits, and improved health status of the patients and their quality of life.…”

Section: Discussionmentioning

confidence: 99%

“…It is erroneous to think that telling patients of side effects will discourage them from using the medication. Holding back information may be disprincipled and patients are authorized to be fully aware of what to look for 8 . Minimum average time consumed for single session of patient counseling was observed as 1.43 minutes while maximum time observed was 6.17 minutes.…”

Section: Discussionmentioning

confidence: 99%

Evaluation of Patient Counseling in Different Hospital of Karachi, Pakistan; A Neglected Domain of Pharmacy

Kafeel¹,

Rukh²,

Naveed³

2014

Int. Res. J. Pharm.

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Patient counseling is a critical component of dispensing process that provides information, advice and assistance to help patients using their medication properly. The objective of our study was to analyze whether patient counseling services are provided or not and how efficiently it is being conducted. For this purpose a questionnaire based cross sectional survey of pharmacists was done in different hospital set ups of the Karachi city with a sample size of 30. The results show that counseling services are provided by all the Hospitals in which survey was conducted, medication charts are used by 15 (50 %) samples while patient education program is not organized by 18 (60 %) samples. The results obtained from the survey conclude that patient counseling is conceptually present in all hospital setups but not done efficiently or in appropriate manner. Steps should be taken by the authorities, pharmacists and the patients to make counseling more effective.

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Medication adherence: a review of pharmacy education, research, practice and policy in Finland

Cited by 7 publications

References 59 publications

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

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

Medication adherence among ambulatory patients with type 2 diabetes in a tertiary healthcare setting in Southwestern Nigeria

Evaluation of Patient Counseling in Different Hospital of Karachi, Pakistan; A Neglected Domain of Pharmacy

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