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Abstract

Medication adherence continues to be a high concern in the medical field, with only about 50% of medications used for chronic conditions taken as prescribed. Several factors contribute to this phenomenon, including patients’ lack of knowledge of the medication and the disease state, their socioeconomic status and living situation, and their relationship with their provider. The literature indicates that there are three major phases of medication adherence – initiation, implementation, and discontinuation – and as patients proceed through these phases, practitioners have an opportunity to impact a patient’s adherence using various tools and techniques.

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References

  • Adams, A. J., & Stolpe, S. F. (2016, May). Defining and measuring primary medication nonadherence: Development of a quality measure. Journal of Managed Care & Specialty Pharmacy, 22(5), 516–523.

    Article  Google Scholar 

  • Albassam, A., & Hughes, D. A. (2021). What should patients do if they miss a dose? A systematic review of patient information leaflets and summaries of product characteristics. European Journal of Clinical Pharmacology, 77, 251–260.

    Article  PubMed  Google Scholar 

  • Barat, I., Andreasen, F., & Damsgaard, E. M. (2001, June). Drug therapy in the elderly: What doctors believe and patients actually do. British Journal of Clinical Pharmacology, 51(6), 615–622.

    Article  PubMed  PubMed Central  Google Scholar 

  • Barcenas, C. H., Zhang, N., Zhao, H., Duan, Z., Buchholz, T. A., Hortobagyi, G. N., & Giordano, S. H. (2012). Anthracycline regimen adherence in older patients with early breast cancer. The Oncologist, 17(3), 303–311.

    Article  PubMed  PubMed Central  Google Scholar 

  • Carney, R. M., Freedland, K. E., Eisen, S. A., Rich, M. W., Skala, J. A., & Jaffe, A. S. (1998). Adherence to a prophylactic medication regimen in patients with symptomatic versus asymptomatic ischemic heart disease. Behavioral Medicine, 24(1), 35–39.

    Article  PubMed  Google Scholar 

  • Checchi, K. D., Huybrechts, K. F., Avorn, J., & Kesselheim, A. S. (2014, September 24). Electronic medication packaging devices and medication adherence: A systematic review. Journal of the American Medical Association, 312(12), 1237–1247.

    Article  PubMed  Google Scholar 

  • Choudhry, N. K., Setoguchi, S., Levin, R., Winkelmayer, W. C., & Shrank, W. H. (2008). Trends in adherence to secondary prevention medications in elderly post-myocardial infarction patients. Pharmacoepidem. Drug Safe, 17,1189–1196.

    Google Scholar 

  • Choudhry, N. K., Fischer, M. A., Avorn, J., Schneeweiss, S., Solomon, D. H., Berman, C., Jan, S., Liu, J., Lii, J., Brookhart, M. A., Mahoney, J. J., & Shrank, W. H. (2010, November). At Pitney Bowes, value-based insurance design cut copayments and increased drug adherence. Health Affairs (Millwood), 29(11), 1995–2001.

    Google Scholar 

  • Cramer, J. A., Roy, A., Burrell, A., Fairchild, C. J., Fuldeore, M. J., Ollendorf, D. A., & Wong, P. K. (2008, January–February). Medication compliance and persistence: Terminology and definitions. Value in Health, 11(1), 44–47.

    Article  PubMed  Google Scholar 

  • DiMatteo, M. R., Haskard, K. B., & Williams, S. L. (2007, June). Health beliefs, disease severity, and patient adherence: A meta-analysis. Medical Care, 45(6), 521–528.

    Article  PubMed  Google Scholar 

  • Elsous, A., Radwan, M., Al-Sharif, H., & Abu Mustafa, A. (2017, June 9). Medications adherence and associated factors among patients with type 2 diabetes mellitus in the Gaza Strip, Palestine. Front Endocrinol (Lausanne), 8, 100.

    Article  Google Scholar 

  • Fialová, D., & Onder, G. (2009, June). Medication errors in elderly people: Contributing factors and future perspectives. British Journal of Clinical Pharmacology, 67(6), 641–645.

    Article  PubMed  PubMed Central  Google Scholar 

  • Fischer, M., Choudhry, N., Bykov, K., Brill, G., Bopp, G., Wurst, A., & Shrank, W. (2014). Pharmacy-based interventions to reduce primary medication nonadherence to cardiovascular medications. Medical Care, 52(12), 1050–1054.

    Article  PubMed  Google Scholar 

  • Gajria, K., Lu, M., Sikirica, V., Greven, P., Zhong, Y., Qin, P., & Xie, J. (2014). Adherence, persistence, and medication discontinuation in patients with attention-deficit/hyperactivity disorder – A systematic literature review. Neuropsychiatric Disease and Treatment, 10, 1543–1569.

    PubMed  PubMed Central  Google Scholar 

  • Gast, A., & Mathes, T. (2019, May 10). Medication adherence influencing factors-an (updated) overview of systematic reviews. Systematic Reviews, 8(1), 112.

    Article  PubMed  PubMed Central  Google Scholar 

  • Gellad, W. F., Haas, J. S., & Safran, D. G. (2007, November). Race/ethnicity and nonadherence to prescription medications among seniors: Results of a national study. Journal of General Internal Medicine, 22(11), 1572–1578.

    Article  PubMed  PubMed Central  Google Scholar 

  • Gellad, W. F., Grenard, J. L., & Marcum, Z. A. (2011, February). A systematic review of barriers to medication adherence in the elderly: Looking beyond cost and regimen complexity. The American Journal of Geriatric Pharmacotherapy, 9(1), 11–23.

    Article  PubMed  PubMed Central  Google Scholar 

  • Gleason, P. P., Starner, C. I., Gunderson, B. W., Schafer, J. A., & Sarran, H. S. (2009, October). Association of prescription abandonment with cost share for high-cost specialty pharmacy medications. Journal of Managed Care Pharmacy, 15(8), 648–658.

    Article  PubMed  Google Scholar 

  • Grenard, J. L., Munjas, B. A., Adams, J. L., et al. (2011). Depression and medication adherence in the treatment of chronic diseases in the United States: A meta-analysis. Journal of General Internal Medicine, 26, 1175–1182.

    Article  PubMed  PubMed Central  Google Scholar 

  • Gu, L., Wu, S., Zhao, S., Zhou, H., Zhang, S., Gao, M., Qu, Z., Zhang, W., & Tian, D. (2017, December 6). Association of social support and medication adherence in Chinese patients with type 2 diabetes mellitus. International Journal of Environmental Research and Public Health, 14(12), 1522.

    Article  PubMed Central  Google Scholar 

  • Hutchins, D. S., Zeber, J. E., Roberts, C. S., Williams, A. F., Manias, E., Peterson, A. M., & IPSOR Medication Adherence and Persistence Special Interest Group. (2015, July). Initial medication adherence-review and recommendations for good practices in outcomes research: An ISPOR Medication Adherence and Persistence Special Interest Group report. Value in Health, 18(5), 690–699.

    Article  PubMed  Google Scholar 

  • Jin, H., Kim, Y., & Rhie, S. J. (2016, October 19). Factors affecting medication adherence in elderly people. Patient Preference and Adherence, 10, 2117–2125.

    Article  PubMed  PubMed Central  Google Scholar 

  • Kelly, J., D’Cruz, G., & Wright, D. (2010, January). Patients with dysphagia: Experiences of taking medication. Journal of Advanced Nursing, 66(1), 82–91.

    Article  PubMed  Google Scholar 

  • Krueger, K., Botermann, L., Schorr, S. G., Griese-Mammen, N., Laufs, U., & Schulz, M. (2015, April 1). Age-related medication adherence in patients with chronic heart failure: A systematic literature review. International Journal of Cardiology, 184, 728–735.

    Article  PubMed  Google Scholar 

  • Lee, S. K., Kang, B. Y., Kim, H. G., & Son, Y. J. (2013, March). Predictors of medication adherence in elderly patients with chronic diseases using support vector machine models. Healthcare Information Research, 19(1), 33–41.

    Google Scholar 

  • Lehmann, A., Aslani, P., Ahmed, R., Celio, J., Gauchet, A., Bedouch, P., Bugnon, O., Allenet, B., & Schneider, M. P. (2014, February). Assessing medication adherence: Options to consider. International Journal of Clinical Pharmacy, 36(1), 55–69.

    Article  PubMed  Google Scholar 

  • Lanham A, Cochran G, Klepser D. (2016). Electronic prescriptions: opportunities and challenges for the patient and pharmacist. Advanced Health Care Technologies, 2, 1–11.

    Google Scholar 

  • Miller, T. A. (2016, July). Health literacy and adherence to medical treatment in chronic and acute illness: A meta-analysis. Patient Education and Counseling, 99(7), 1079–1086.

    Article  PubMed  PubMed Central  Google Scholar 

  • Osterberg, L., & Blaschke, T. (2005). Adherence to medication. The New England Journal of Medicine, 353, 487–497; 3.

    Google Scholar 

  • Pasma, A., van’t Spijker, A., Hazes, J. M. W., Busschbach, J. J. V., & Luime, J. J. (2013). Factors associated with adherence to pharmaceutical treatment for rheumatoid arthritis patients: A systematic review. Seminars in Arthritis and Rheumatism, 43(1), 18–28.

    Article  PubMed  Google Scholar 

  • Paterson, D. L., Swindells, S., Mohr, J., Brester, M., Vergis, E. N., Squier, C., Wagener, M. M., & Singh, N. (2000, July 4). Adherence to protease inhibitor therapy and outcomes in patients with HIV infection. Annals of Internal Medicine, 133(1), 21–30.

    Article  PubMed  Google Scholar 

  • Pednekar, P., & Peterson, A. (2018, June 4). Mapping pharmacy deserts and determining accessibility to community pharmacy services for elderly enrolled in a State Pharmaceutical Assistance Program. PLoS One, 13(6), e0198173.

    Article  PubMed  PubMed Central  Google Scholar 

  • Peterson, A. M., Takiya, L., & Finley, R. (2003, April 1). Meta-analysis of trials of interventions to improve medication adherence. American Journal of Health-System Pharmacy, 60(7), 657–665.

    Article  PubMed  Google Scholar 

  • Raehl, C. L., Bond, C. A., Woods, T. J., Patry, R. A., & Sleeper, R. B. (2006, May). Screening tests for intended medication adherence among the elderly. The Annals of Pharmacotherapy, 40(5), 888–893.

    Article  PubMed  Google Scholar 

  • Raji, M. A., Kuo, Y. F., Salazar, J. A., Satish, S., & Goodwin, J. S. (2004, February). Ethnic differences in antihypertensive medication use in the elderly. The Annals of Pharmacotherapy, 38(2), 209–214.

    Article  PubMed  Google Scholar 

  • Rathbone, A. P., Jamie, K., Todd, A., & Husband, A. (2021). A qualitative study exploring the lived experience of medication use in different disease states: Linking experiences of disease symptoms to medication adherence. Journal of Clinical Pharmacy and Therapeutics, 46, 352–362.

    Article  PubMed  Google Scholar 

  • Rhee, H., Wicks, M. N., Dolgoff, J. S., Love, T. M., & Harrington, D. (2018, May 24). Cognitive factors predict medication adherence and asthma control in urban adolescents with asthma. Patient Preference and Adherence, 12, 929–937.

    Article  PubMed  PubMed Central  Google Scholar 

  • Roborel de Climens, A., Pain, E., Boss, A., & Shaunik, A. (2020, August). Understanding reasons for treatment discontinuation, attitudes and education needs among people who discontinue type 2 diabetes treatment: Results from an online patient survey in the USA and UK. Diabetes Therapy, 11(8), 1873–1881.

    Article  PubMed  PubMed Central  Google Scholar 

  • Rolnick, S. J., Pawloski, P. A., Hedblom, B. D., Asche, S. E., & Bruzek, R. J. (2013, June). Patient characteristics associated with medication adherence. Clinical Medicine & Research, 11(2), 54–65.

    Article  Google Scholar 

  • Ruppar, T. M., Delgado, J. M., & Temple, J. (2015, October). Medication adherence interventions for heart failure patients: A meta-analysis. European Journal of Cardiovascular Nursing, 14(5), 395–404.

    Article  PubMed  Google Scholar 

  • Sabaté, E. (Ed.). (2003). Adherence to long-term therapies: Evidence for action. World Health Organization.

    Google Scholar 

  • Schoenthaler, A., Montague, E., Baier Manwell, L., Brown, R., Schwartz, M. D., & Linzer, M. (2014). Patient-physician racial/ethnic concordance and blood pressure control: The role of trust and medication adherence. Ethnicity & Health, 19(5), 565–578.

    Article  Google Scholar 

  • Schwartz, K. A., Schwartz, D. E., Ghosheh, K., Reeves, M. J., Barber, K., & DeFranco, A. (2005, April 15). Compliance as a critical consideration in patients who appear to be resistant to aspirin after healing of myocardial infarction. The American Journal of Cardiology, 95(8), 973–975.

    Article  PubMed  Google Scholar 

  • Shrank, W. H., Choudhry, N. K., Fischer, M. A., Avorn, J., Powell, M., Schneeweiss, S., Liberman, J. N., Dollear, T., Brennan, T. A., & Brookhart, M. A. (2010, November 16). The epidemiology of prescriptions abandoned at the pharmacy. Annals of Internal Medicine, 153(10), 633–640.

    Article  PubMed  Google Scholar 

  • Shruthi, R., Jyothi, R., Pundarikaksha, H. P., Nagesh, G. N., & Tushar, T. J. (2016, Descember). A study of medication compliance in geriatric patients with chronic illnesses at a tertiary care hospital. Journal of Clinical and Diagnostic Research, 10(12), FC40–FC43.

    Google Scholar 

  • Srivastava, K., Arora, A., Kataria, A., Cappelleri, J. C., Sadosky, A., & Peterson, A. M. (2013, May 20). Impact of reducing dosing frequency on adherence to oral therapies: A literature review and meta-analysis. Patient Preference and Adherence, 7, 419–434.

    PubMed  PubMed Central  Google Scholar 

  • Tan, X., Patel, I., Chang, J., et al. (2014). Review of the four item Morisky Medication Adherence Scale (MMAS-4) and eight item Morisky Medication Adherence Scale (MMAS-8). Innovations of Pharmacy, 5(3), Article 165.

    Article  Google Scholar 

  • Velligan, D. I., Sajatovic, M., Hatch, A., Kramata, P., & Docherty, J. P. (2017, March 3). Why do psychiatric patients stop antipsychotic medication? A systematic review of reasons for nonadherence to medication in patients with serious mental illness. Patient Preference and Adherence, 11, 449–468.

    Article  PubMed  PubMed Central  Google Scholar 

  • Viswanathan, M., Golin, C. E., Jones, C. D., Ashok, M., Blalock, S. J., Wines, R. C., Coker-Schwimmer, E. J., Rosen, D. L., Sista, P., & Lohr, K. N. (2012, December 4). Interventions to improve adherence to self-administered medications for chronic diseases in the United States: A systematic review. Annals of Internal Medicine, 157(11), 785–795.

    Article  PubMed  Google Scholar 

  • Vrijens, B., De Geest, S., Hughes, D. A., Przemyslaw, K., Demonceau, J., Ruppar, T., Dobbels, F., Fargher, E., Morrison, V., Lewek, P., Matyjaszczyk, M., Mshelia, C., Clyne, W., Aronson, J. K., Urquhart, J., & ABC Project Team. (2012, May). A new taxonomy for describing and defining adherence to medications. British Journal of Clinical Pharmacology, 73(5), 691–705.

    Article  PubMed  PubMed Central  Google Scholar 

  • Zeber, J. E., Manias, E., Williams, A. F., Hutchins, D., Udezi, W. A., Roberts, C. S., Peterson, A. M., & ISPOR Medication Adherence Good Research Practices Working Group. (2013, July–August). A systematic literature review of psychosocial and behavioral factors associated with initial medication adherence: A report of the ISPOR medication adherence & persistence special interest group. Value in Health, 16(5), 891–900.

    Article  PubMed  Google Scholar 

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Peterson, A.M. (2021). Medication Adherence in Primary Care. In: O’Donohue, W., Zimmermann, M. (eds) Handbook of Evidence-Based Prevention of Behavioral Disorders in Integrated Care. Springer, Cham. https://doi.org/10.1007/978-3-030-83469-2_14

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