Medication nonadherence, a scenario where patients do not take their medications as prescribed, is a widespread issue. Surprisingly, research indicates that about half the time, patients fail to adhere to their medication regimen. This nonadherence is particularly concerning for patients with chronic diseases.
For healthcare professionals, understanding the reasons behind medication nonadherence is crucial to improve patient compliance.
The Fear of Side Effects
One of the common reasons patients intentionally avoid taking their medications is the fear of potential side effects.
This fear may stem from personal experience with side effects from the same or similar medication or from witnessing side effects in friends or family members. The latter creates a belief in patients that the medication was the cause of the problems observed in others.
The Financial Barrier
The cost of medications is a significant barrier to adherence. High costs may deter patients from filling their prescriptions or lead them to ration their supply.
Healthcare professionals can address this by ensuring that the prescribed drug is on the patient’s insurance formulary or by prescribing medications known to be on discount lists.
Misunderstanding the Medication
Patients may not understand the necessity of the medication, the nature of the side effects, or the time required to see results. This is particularly true for chronic illnesses where medication is taken to reduce the risk of adverse events. Educating patients about the importance of medication in managing their condition is vital.
The Burden of Polypharmacy
Patients on multiple medications with complex dosing schedules are likely to be non-adherent. Simplifying dosing schedules, prescribing long-acting drugs, and using combination products can alleviate the burden of polypharmacy.
Absence of Symptoms
Patients who do not experience symptoms or feel different when starting or stopping the medication may not see a reason to take it. Moreover, once a condition is controlled, patients may erroneously believe the problem is resolved. It is essential to inform patients that they may need long-term medication.
Mistrust and Skepticism
Patients may be skeptical of their physician’s motives for prescribing certain medications, especially with news coverage highlighting the influence of pharmaceutical companies on prescribing patterns. Building patient trust is key to addressing this concern.
Fear of Dependency
Concerns about becoming dependent on medication can lead to non-adherence. Enhancing patient-physician communication is critical in this regard. Inadequate communication accounts for 55% of medication nonadherence, highlighting the importance of understanding the patient’s reasons for non-adherence.
Depression and Mental Health
Depressed patients are less likely to adhere to their medication regimen. Healthcare professionals can address this by discussing issues relating to the patient’s experiences, reducing embarrassment, and expressing that many patients face similar challenges.
Conclusion: A Multi-faceted Approach
Addressing medication nonadherence requires a multi-faceted approach that includes patient education, simplifying medication regimens, building trust, and addressing financial barriers.
The American Medical Association’s STEPS Forward® toolkit, titled “Medication Adherence: Improve Patient Outcomes and Reduce Costs,” toolkit provides valuable resources for healthcare professionals to improve medication adherence.
Healthcare professionals can significantly impact patient outcomes and reduce healthcare costs through a personalized approach and patient involvement in treatment plans.