176su.doc
Improving patients' medication adherence in chronic deseases
Čulig J, Leppée M, Erić M, Bošković J.
Adherence to long-term therapy is defined as the extent to which a patients' behaviour
corresponds with agreed recommendations from a health care provider. According to World
Health Organization adherence among patients suffering chronic diseases in developed
country averages only 50%.
The objective of this study was to investigate the reasons of patient's non-adherence to
prescribed therapy in order to identify the ways in which adherence could best be improved
by pharmacists.
Patients with diagnosed chronic diseases filled self-reported questionnaire with questions
containing information about the reasons for not taking their medication as prescribed,
whether pharmacists checked patients' adherence to their therapies, and how often they did it.
This study has involved 171 community pharmacies in the city of Zagreb.
Results from 180 self-reported questionnaries show response rate 33%. There were 16 offered
reasons for patients' non-adherence. The most frequently reported reasons were the following:
forgetfulness (53%), „ran out of pills“ (40%), away from home (36%), problems with taking
pills at specified times (with meals, on empty stomach etc.) (34%), problems with taking more
than one medicine at the same time (31%). More than half of the patients (59%) stated that
pharmacists always checked whether patients' took their medicines for the first time. 64% of
patients thought that pharmacists do not check how often they miss their doses.
By tailoring individual patient medication plan, giving more advice on hoe to deal with
complex drug regimen, checking how often patient miss their doses and asking patient to
repeat aloud how they should take their medication, pharmacist can increase patient adherence
to long term therapy and in the end therapy effectiveness, patient safety, quality of patient life
and rationalize drug expenditure.