Adherence and compliance are used interchangeably in medical literature. Although there is argument on how both terms are defined, ultimately it refers to the same point, which is being constant with medication. In the US, non-adherence to medication causes 125,000 deaths annually and accounts for 10% to 25% of hospital and nursing home admissions.

Although non-adherence to medications is a concern, awareness on this matter is quite low. Studies have shown that in general, about 40% of patients are non-adherent to medication. What is more worrying is that non-adherence can reach up to 70% if medication regimen is coupled with other changes such as lifestyle changes.

These are a few steps that a doctor can take to improve patient compliance to medication:

1. Simplify

The medication regimen should be simplified as much as possible. As mentioned before, the complex regimen is likely one of the reasons for non-adherence among patients. A doctor should prescribe a medication that can be taken once a day instead 2 to 3 times a day. A long acting drug and a pill with more than one drug or actions should be prescribed if possible.

Based on a study done in Nova Scotia, Canada, hypertensive patients were more likely to have a good refill adherence if the medication was once a day. It is also a good idea to prescribe medication based on the patients’ daily activities.

2. Improve patient understanding

Research has shown that a patient who understands the purpose of the prescription is twice more likely to adhere to medication. Thus, this further requires a doctor to improve the communication with patients and help them to understand the purpose of the medication.

However, it should be noted that every patient has different educational backgrounds and learning capabilities. A physician should use simple, everyday language and avoid using complex medical terms.

Healthcare practitioners can take certain measures to get patients to remember what they have told them; these include limiting instructions to three or four major points during discussion, using simple and precise words especially when explaining the diagnosis and giving instructions, supplementing oral teaching with written materials, keeping the patient’s family members and friends in the loop, and reinforcing what has been discussed.

3. Modify to suit the patients’ beliefs

Knowledge alone is inadequate in improving medication compliance, especially in complex regimen therapy. For example, in treating diabetes mellitus, a patient not only needs to take medication but also needs to change his or her lifestyle, especially diet and exercise.

A patient needs to understand that he is putting his health at risk if he neglects his medication. Additionally, a doctor needs to put in effort in explaining the importance of medication to the patient. For example, a doctor can point out the benefits of the treatment even if it is small because often, a patient is ignorant to its benefits and feels that the treatment is pointless.

Needless to say, a doctor should assess patient compliance to medication so that any problems can be properly addressed. A simple method such as self-reports should be sufficient. Furthermore, a regular assessment by a physician also can lead to improving patient compliance to medication. MIMS

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