The treatment of chronic illnesses commonly includes the long-term use of pharmacotherapy. Although these medications are effective in combating disease, their full benefits are often not realized because approximately 50% of patients do not take their medications as prescribed. Factors contributing to poor medication adherence are myriad and include those that are related to patients (eg, suboptimal health literacy and lack of involvement in the treatment decision\u2013making process), those that are related to physicians (eg, prescription of complex drug regimens, communication barriers, ineffective communication of information about adverse effects, and provision of care by multiple physicians), and those that are related to health care systems (eg, office visit time limitations, limited access to care, and lack of health information technology). Because barriers to medication adherence are complex and varied, solutions to improve adherence must be multifactorial.\u00a0<\/p>\n\n\n\n
In its 2003 report on medication adherence,1<\/a><\/sup>\u00a0the World Health Organization (WHO) quoted the statement by Haynes et al that \u201cincreasing the effectiveness of adherence interventions may have a far greater impact on the health of the population than any improvement in specific medical treatments.\u201d Among patients with chronic illness, approximately 50% do not take medications as prescribed.1<\/a>,2<\/a><\/sup>\u00a0This poor adherence to medication leads to increased morbidity and death and is estimated to incur costs of approximately $100 billion per year.3<\/a><\/sup>\u00a0Thus, Hippocrates’ exhortation to the physician to \u201cnot only be prepared to do what is right himself, but also to make the patient\u2026cooperate\u201d4<\/a><\/sup>\u00a0has consistently failed for more than 2000 years. Today’s ever more complicated medical regimens make it even less likely that physicians will be able to compel compliance and more important that they partner with patients in doing what is right together.<\/p>\n\n\n\n Medication-taking behavior is extremely complex and individual, requiring numerous multifactorial strategies to improve adherence. An enormous amount of research has resulted in the development of medications with proven efficacy and positive benefit-to-risk profiles. This millennium has seen a new and greater focus on outcomes. However, we seem to have forgotten that between the former and the latter lies medication adherence:Treatment \u2192 Adherence \u2192 Outcomes<\/p>\n\n\n\n The WHO defines adherence to long-term therapy as \u201cthe extent to which a person’s behavior\u2014taking medication, following a diet, and\/or executing lifestyle changes\u2014corresponds with agreed recommendations from a health care provider.\u201d1<\/a><\/sup>\u00a0Often, the terms\u00a0adherence<\/em>\u00a0and\u00a0compliance<\/em>\u00a0are used interchangeably. However, their connotations are somewhat different:\u00a0adherence<\/em>\u00a0presumes the patient’s agreement with the recommendations, whereas\u00a0compliance<\/em>\u00a0implies patient passivity. As described by Steiner and Earnest,5<\/a><\/sup>\u00a0both terms are problematic in describing medication-taking behavior because they \u201cexaggerate the physician’s control over the process of taking medications.\u201d The complex issues surrounding the taking of medication for chronic disease cannot easily be distilled into one word. Recognition of this complexity will help avoid assigning blame exclusively to the patient and assist in identifying effective solutions.<\/p>\n\n\n\n This article breaks down the issues with medication adherence into three categories: patients, physicians, and health care systems. These three categories overlap in many ways which means a solution needs to touch at least two of the categories to be an effective one. These three categories have a causation relationship. Ineffective medication adherence rooted in a physician’s actions causes lower pharmaceutical literacy amongst health care systems and patients. Another key takeaway is the difficulty of identifying non-adherence amongst patients. Building a better sense of trust between patient and physician as well as between patient and health care systems will result in better overall health care.<\/p>\n","protected":false},"excerpt":{"rendered":" The treatment of chronic illnesses commonly includes the long-term use of pharmacotherapy. Although these medications are effective in combating disease, their full benefits are often not realized because approximately 50% of patients do not take their medications as prescribed. Factors contributing to poor medication adherence are myriad and include those that are related to patients […]<\/p>\n","protected":false},"author":41,"featured_media":6988,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[26],"tags":[],"class_list":{"0":"post-6987","1":"post","2":"type-post","3":"status-publish","4":"format-standard","5":"has-post-thumbnail","7":"category-focus"},"_links":{"self":[{"href":"https:\/\/desis.osu.edu\/seniorthesis\/index.php\/wp-json\/wp\/v2\/posts\/6987","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/desis.osu.edu\/seniorthesis\/index.php\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/desis.osu.edu\/seniorthesis\/index.php\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/desis.osu.edu\/seniorthesis\/index.php\/wp-json\/wp\/v2\/users\/41"}],"replies":[{"embeddable":true,"href":"https:\/\/desis.osu.edu\/seniorthesis\/index.php\/wp-json\/wp\/v2\/comments?post=6987"}],"version-history":[{"count":1,"href":"https:\/\/desis.osu.edu\/seniorthesis\/index.php\/wp-json\/wp\/v2\/posts\/6987\/revisions"}],"predecessor-version":[{"id":6989,"href":"https:\/\/desis.osu.edu\/seniorthesis\/index.php\/wp-json\/wp\/v2\/posts\/6987\/revisions\/6989"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/desis.osu.edu\/seniorthesis\/index.php\/wp-json\/wp\/v2\/media\/6988"}],"wp:attachment":[{"href":"https:\/\/desis.osu.edu\/seniorthesis\/index.php\/wp-json\/wp\/v2\/media?parent=6987"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/desis.osu.edu\/seniorthesis\/index.php\/wp-json\/wp\/v2\/categories?post=6987"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/desis.osu.edu\/seniorthesis\/index.php\/wp-json\/wp\/v2\/tags?post=6987"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}Article Highlights<\/h3>\n\n\n\n
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