Non-Adherence: Put It To Good Use

 

An article by The Pharmaceutical Journal labels non-adherence as ‘medicine’s weakest link’.

Non-adherence has a huge impact on patient outcomes. If patients do not take their medication as prescribed, they are more likely to become unwell. They may also struggle to control long-term chronic conditions. It is estimated that around half of people do not take their medication properly. This figure increases with age and the number of medications a person takes. (1)

 

The Implications of Non-Adherence

The collective effect of this is debilitating for the NHS. Wasted medication alone costs the NHS more than £300 million every year. (2) This accounts only for the unused medication. This does not begin to address the price of extra resources. Reduced patient health leads to increased GP appointments and hospital admissions. The avoidable costs relating to this are perpetual. Extra scanning, testing and treatment costs arise as a direct result of non-adherence.

Non-adherence is an age-old tale for healthcare professionals. We see it on a daily basis. Though we understand the issue, it can be difficult to identify effective solutions for our patients. Obstructions to administration result from a plethora of reasons. Patients may dislike swallowing tablets, neglect to read the instructions or simply forget.

 

But, non-adherence is a growing problem. This is in part due to increased life expectancy and chronic illness being on the rise.

 

The Royal Pharmaceutical Society recommends 4 guiding principles for optimising patient outcomes. These are:

 

  1. Aim to understand the patient’s experience
  2. Evidence based choice of medicines
  3. Ensure medicines use is as safe as possible
  4. Make medicines optimisation part of routine practice (3)

Though these are fairly general recommendations, they are a helpful reminder.

 

Implementing guidelines.

 

Patient experience is at the heart of what we do at PillTime. We tackle non-adherence through striving to understand patient frustrations and behaviours.

Evidence can point us in the right direction. For example, we may know that teenage diabetics are more likely to be non-compliant. (4) But, this evidence may not tell us everything about our patients? non-adherence.

Trends, patient feedback and evidence-based research give us a holistic view. As an online pharmacy, we are lucky in having a constant stream of feedback online. This provides us with invaluable insight.

For example, we have learned that many of our patients consider environmental factors. We can thus provide a medication experience that aligns with their values.

It’s the same for adherence. If medication fits in with a patient’s values and habits, they are more likely to take it.

 

Doctor giving patient a personalised plan

You are the weakest link, goodbye.

Is The Pharmaceutical Journal’s statement a fair one? (5)

Non-adherence results in poor patient outcomes, ill health and increased NHS spending. But viewing it as ‘medicine’s weakest link’ may be more of a hindrance than a help. Whilst we need to be aware of the problem at hand, viewing non-adherence in a different light may be more useful to us.

What may make us better equipped to tackle non-adherence on a personal level? Treating incidences of non-adherence as opportunities to solve problems for our patients.

Understanding patient?s individual issues can help us identify strategies to improve outcomes. This personalisation is key in helping our patients take their medication properly. NICE’s 2015 recommendations provide more insight on personalised solutions. (4)

Using this strategy does not mean we want non-adherence to occur. Rather, that we view it as an opportunity to gain insight on patient experience.

 

Non-adherence thus becomes a powerful tool for improvement. It would be impossible to understand the issues facing every patient. But developing targeted measures to prevent what we can is a step in the right direction.

 

References:

 

  1. World Health Organisation. (2003). The World Health Report 2003: Shaping the Future. http://www.who.int/whr/2003/en/whr03_en.pdf Accessed 21.08.18.
  2. (2010;341:c6799). Doi: https://doi.org/10.1136/bmj.c6799 Accessed: 21.08.18
  3. NICE. (2015). Medicines optimisation: the safe and effective use of medicines to enable the best possible outcomes. https://www.nice.org.uk/guidance/ng5/chapter/1-Recommendations Accessed 21.08.18.
  4. org. (2013). Non-Compliance in Teenage Diabetics. https://forum.diabetes.org.uk/boards/threads/non-compliance-in-teenage-diabetes.36957/ Accessed 21.08.18.
  5. Oswald, K. (2018). Non-Adherence: Medicine’s Weakest Link. https://www.pharmaceutical-journal.com/news-and-analysis/features/non-adherence-medicines-weakest-link/20204378.article?firstPass=false Accessed 21.08.18.
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