Medication Nonadherence: Implications for Patient Health Outcomes in Pharmacy Practice

Ahmed Alaa Al-Temimi; Sunanthiny Krishnan; Anisha Kaur Sandhu; Nida  Sajid Ali Bangash

doi:10.22146/ijp.2236

Ahmed Alaa Al-Temimi School of Pharmacy, Monash University Malaysia, Bandar Sunway, Selangor, Malaysia https://orcid.org/0000-0002-9112-5874
Sunanthiny Krishnan School of Pharmacy, Monash University Malaysia, Bandar Sunway, Selangor, Malaysia
Anisha Kaur Sandhu School of Pharmacy, Monash University Malaysia, Bandar Sunway, Selangor, Malaysia
Nida Sajid Ali Bangash School of Pharmacy, Monash University Malaysia, Bandar Sunway, Selangor, Malaysia

Keywords: Medication nonadherence, Healthcare quality, Patient-Drug Compliance, Clinical Pharmacy

Abstract

The primary objective of this review is (1) to better understand the prevalence and impact of medication nonadherence, (2) to identify risk factors for medication nonadherence, (3) to understand the association between nonadherence and its implications on patient health outcomes in pharmacy practice, and (4) to study interventions designed to improve patient adherence to prescribed medications for medical conditions, considering its impact on both medication adherence and patient health outcomes. Narrative review design by critical analysis of the literature of published paper-based journal articles were manually sorted. Additional references were obtained from citations within the retrieved articles. This narrative review surveyed the findings of the identified articles with data extracted to presents various strategies and resources on medication nonadherence related to patients and healthcare providers. Out of 121 published articles, only 64 articles have been considered according to surveyed identified articles to determine both subjective and objective medication adherence measures. The research in this field needs advances, including improved design of feasible long‐term interventions, objective adherence measures, and sufficient study power to detect improvements in patient health outcomes. Current methods of improving medication adherence for chronic health problems are mostly complex and ineffective so full benefits of treatment cannot be realized. To date, monitoring of patient medication adherence and use of interventions to improve adherence are rare in routine clinical practice.

References

Ahmad, N. S., Ramli, A., Islahudin, F., and Paraidathathu, T. (2013). Medication adherence in patients with type 2 diabetes mellitus treated at primary health clinics in Malaysia. Patient preference and adherence, 7, 525.

Ali, S. M., and Jusoff, K. (2009). Barriers to optimal control of type 2 diabetes in Malaysian Malay patients. Global Journal of Health Science, 1(2), 106.

Ammassari, A., Murri, R., Pezzotti, P., Trotta, M. P., Ravasio, L., De Longis, P., . . . Carosi, G. (2001). Self-reported symptoms and medication side effects influence adherence to highly active antiretroviral therapy in persons with HIV infection. Journal of acquired immune deficiency syndromes (1999), 28(5), 445-449.

Balamurugan, A., Ohsfeldt, R., Hughes, T., and Phillips, M. (2006). Diabetes self-management education program for Medicaid recipients. The Diabetes Educator, 32(6), 893-900.

Basco, M. R., and Smith, J. (2009). Faulty Decision-Making: Impact on Treatment Adherence in Bipolar Disorder. Primary Psychiatry, 16(8).

Benner, J. S., Chapman, R. H., Petrilla, A. A., Tang, S. S., Rosenberg, N., and Schwartz, J. S. (2009). Association between prescription burden and medication adherence in patients initiating antihypertensive and lipid-lowering therapy. American journal of health-system pharmacy, 66(16), 1471-1477.

Brown, M. T., and Bussell, J. K. (2011). Medication adherence: WHO cares? Paper presented at the Mayo clinic proceedings.

Chiatti, C., Bustacchini, S., Furneri, G., Mantovani, L., Cristiani, M., Misuraca, C., and Lattanzio, F. (2012). The economic burden of inappropriate drug prescribing, lack of adherence and compliance, adverse drug events in older people. Drug safety, 35(1), 73-87.

Claxton, A. J., Cramer, J., and Pierce, C. (2001). A systematic review of the associations between dose regimens and medication compliance. Clinical therapeutics, 23(8), 1296-1310.

Coetzee, B., Kagee, A., and Bland, R. (2016). Shortcomings of adherence counselling provided to caregivers of children receiving antiretroviral therapy in rural South Africa. AIDS care, 28(sup2), 60-65.

Dew, M. A., DiMartini, A. F., Dabbs, A. D. V., Zomak, R., De Geest, S., Dobbels, F., . . . Steel, J. L. (2008). Adherence to the medical regimen during the first two years after lung transplantation. Transplantation, 85(2), 193.

Diaz, E., Levine, H. B., Sullivan, M. C., Sernyak, M. J., Hawkins, K. A., Cramer, J. A., and Woods, S. W. (2001). Use of the Medication Event Monitoring System to estimate medication compliance in patients with schizophrenia. Journal of Psychiatry and Neuroscience, 26(4), 325.

DiMatteo, M. R., Haskard, K. B., and Williams, S. L. (2007). Health beliefs, disease severity, and patient adherence: a meta-analysis. Medical care, 521-528.

Dunn, S. P., Birtcher, K. K., Beavers, C. J., Baker, W. L., Brouse, S. D., Page, R. L., . . . Walsh, M. N. (2015). The role of the clinical pharmacist in the care of patients with cardiovascular disease. Journal of the American College of Cardiology, 66(19), 2129-2139.

Egan, B. M., Lackland, D. T., and Cutler, N. E. (2003). Awareness, knowledge, and attitudes of older Americans about high blood pressure: implications for health care policy, education, and research. Archives of Internal Medicine, 163(6), 681-687.

Ellis, D. A., Naar-King, S., Chen, X., Moltz, K., Cunningham, P. B., and Idalski-Carcone, A. (2012). Multisystemic therapy compared to telephone support for youth with poorly controlled diabetes: Findings from a randomized controlled trial. Annals of Behavioral Medicine, 44(2), 207-215.

Fairman, K. A., and Motheral, B. (2000). Evaluating medication adherence: which measure is right for your program? Journal of managed care pharmacy, 6(6), 499-506.

Farmer, K. C. (1999). Methods for measuring and monitoring medication regimen adherence in clinical trials and clinical practice. Clinical therapeutics, 21(6), 1074-1090.

Garner, J. B. (2010). Problems of nonadherence in cardiology and proposals to improve outcomes. The American journal of cardiology, 105(10), 1495-1501.

Geboers, B., Brainard, J. S., Loke, Y. K., Jansen, C. J., Salter, C., Reijneveld, S. A., and de Winter, A. F. (2015). The association of health literacy with adherence in older adults, and its role in interventions: a systematic meta-review. BMC public health, 15(1), 1-10.

Gellad, W. F., Grenard, J. L., and McGlynn, E. A. (2009). A review of barriers to medication adherence: a framework for driving policy options.

Gellad, W. F., Haas, J. S., and Safran, D. G. (2007). Race/ethnicity and nonadherence to prescription medications among seniors: results of a national study. Journal of general internal medicine, 22(11), 1572-1578.

Gensichen, J., von Korff, M., Peitz, M., Muth, C., Beyer, M., Güthlin, C., . . . König, J. (2009). Case management for depression by health care assistants in small primary care practices: a cluster randomized trial. Annals of Internal Medicine, 151(6), 369-378.

Gray, T., Fenerty, C., Harper, R., Spencer, A., Campbell, M., Henson, D., and Waterman, H. (2012). Individualised patient care as an adjunct to standard care for promoting adherence to ocular hypotensive therapy: an exploratory randomised controlled trial. Eye, 26(3), 407-417.

Hassan, Y., Al-Temimi, A. A., Ramli, R., Saad, M. F. M., and Aziz, N. A. (2019). Difficulties Facing the Patients and Extra Burden for Healthcare Providers by Non-adherence to the Medications-A Comprehensive Review. INDIAN JOURNAL OF PHARMACEUTICAL EDUCATION AND RESEARCH, 53(4), S487-S499.

Horne, R., Weinman, J., Barber, N., Elliott, R., Morgan, M., Cribb, A., and Kellar, I. (2005). Concordance, adherence and compliance in medicine taking. London: NCCSDO, 2005, 40-46.

Jimmy, B., and Jose, J. (2011). Patient medication adherence: measures in daily practice. Oman medical journal, 26(3), 155.

Kato, P. M., Cole, S. W., Bradlyn, A. S., and Pollock, B. H. (2008). A video game improves behavioral outcomes in adolescents and young adults with cancer: a randomized trial. Pediatrics, 122(2), e305-e317.

Katz, M. G., Kripalani, S., and Weiss, B. D. (2006). Use of pictorial aids in medication instructions: a review of the literature. American journal of health-system pharmacy, 63(23), 2391-2397.

Khan, M. U., Shah, S., and Hameed, T. (2014). Barriers to and determinants of medication adherence among hypertensive patients attended National Health Service Hospital, Sunderland. Journal of pharmacy and bioallied sciences, 6(2), 104.

Kulchaitanaroaj, P., Brooks, J. M., Chaiyakunapruk, N., Goedken, A. M., Chrischilles, E. A., and Carter, B. L. (2017). Cost-utility analysis of physician–pharmacist collaborative intervention for treating hypertension compared with usual care. Journal of hypertension, 35(1), 178-187.

Lam, W. Y., and Fresco, P. (2015). Medication adherence measures: an overview. BioMed research international, 2015.

Leguelinel-Blache, G., Dubois, F., Bouvet, S., Roux-Marson, C., Arnaud, F., Castelli, C., . . . Sotto, A. (2015). Improving patient's primary medication adherence: the value of pharmaceutical counseling. Medicine, 94(41).

Levenson, T., Grammer, L. C., Yarnold, P. R., and Patterson, R. (1997). Cost-effective management of malignant potentially fatal asthma. Paper presented at the Allergy and asthma proceedings.

Lin, G., and Scott, J. (2012). NIH Public Access, 100 (2), 130–134. In.

Maduka, O., and Tobin-West, C. (2013). Adherence counseling and reminder text messages improve uptake of antiretroviral therapy in a tertiary hospital in Nigeria. Nigerian journal of clinical practice, 16(3), 302-308.

Malo, J., Cartier, A., Ghezzo, H., Trudeau, C., Morris, J., and Jennings, B. (1995). Comparison of four-times-a-day and twice-a-day dosing regimens in subjects requiring 1200 μg or less of budesonide to control mild to moderate asthma. Respiratory medicine, 89(8), 537-543.

Manteuffel, M., Williams, S., Chen, W., Verbrugge, R. R., Pittman, D. G., and Steinkellner, A. (2014). Influence of patient sex and gender on medication use, adherence, and prescribing alignment with guidelines. Journal of women's health, 23(2), 112-119.

Martin, L. R., Williams, S. L., Haskard, K. B., and DiMatteo, M. R. (2005). The challenge of patient adherence. Therapeutics and clinical risk management, 1(3), 189.

Mauskopf, J. A. (2001). Why study pharmacoeconomics? Expert review of pharmacoeconomics and outcomes research, 1(1), 1-3.

Mistry, N., Keepanasseril, A., Wilczynski, N. L., Nieuwlaat, R., Ravall, M., Haynes, R. B., and Team, P. A. R. (2015). Technology-mediated interventions for enhancing medication adherence. Journal of the American Medical Informatics Association, 22(e1), e177-e193.

Monedero, I., and Caminero, J. (2011). Evidence for promoting fixed-dose combination drugs in tuberculosis treatment and control: a review [Unresolved issues]. The International Journal of Tuberculosis and Lung Disease, 15(4), 433-439.

Morisky, D. E., Ang, A., Krousel‐Wood, M., and Ward, H. J. (2008). Predictive validity of a medication adherence measure in an outpatient setting. The journal of clinical hypertension, 10(5), 348-354.

Oldenmenger, W. H., Echteld, M. A., de Wit, R., Smitt, P. A. S., Stronks, D. L., Stoter, G., and van der Rijt, C. C. (2007). Analgesic adherence measurement in cancer patients: comparison between electronic monitoring and diary. Journal of pain and symptom management, 34(6), 639-647.

Omran, D., Guirguis, L. M., and Simpson, S. H. (2012). Systematic review of pharmacist interventions to improve adherence to oral antidiabetic medications in people with type 2 diabetes. Canadian Journal of Diabetes, 36(5), 292-299.

Osterberg, L., and Blaschke, T. (2005). Adherence to medication. New England journal of medicine, 353(5), 487-497.

Pedan, A., Varasteh, L. T., and Schneeweiss, S. (2007). Analysis of factors associated with statin adherence in a hierarchical model considering physician, pharmacy, patient, and prescription characteristics. Journal of managed care pharmacy, 13(6), 487-496.

Ramli, A., Ahmad, N. S., and Paraidathathu, T. (2012). Medication adherence among hypertensive patients of primary health clinics in Malaysia. Patient preference and adherence, 6, 613.

Richter, A., Anton, S. E., Koch, P., and Dennett, S. L. (2003). The impact of reducing dose frequency on health outcomes. Clinical therapeutics, 25(8), 2307-2335.

Risser, J., Jacobson, T. A., and Kripalani, S. (2007). Development and psychometric evaluation of the Self-efficacy for Appropriate Medication Use Scale (SEAMS) in low-literacy patients with chronic disease. Journal of nursing measurement, 15(3), 203-219.

Rolnick, S. J., Pawloski, P. A., Hedblom, B. D., Asche, S. E., and Bruzek, R. J. (2013). Patient characteristics associated with medication adherence. Clinical medicine and research, 11(2), 54-65.

Rubak, S., Sandbæk, A., Lauritzen, T., and Christensen, B. (2005). Motivational interviewing: a systematic review and meta-analysis. British journal of general practice, 55(513), 305-312.

Rusdi, A., Robson, N. Z., Muhammad, M., and Mohamad, H. (2008). A fifty-year challenge in managing drug addiction in Malaysia. Journal of University of Malaya Medical Centre (JUMMEC), 11(1).

Sabaté, E., and Sabaté, E. (2003). Adherence to long-term therapies: evidence for action: World Health Organization.

Schackman, B. R., Scott, C. A., Sax, P. E., Losina, E., Wilkin, T. J., McKinnon, J. E., . . . Freedberg, K. A. (2007). Potential risks and benefits of HIV treatment simplification: a simulation model of a proposed clinical trial. Clinical infectious diseases, 45(8), 1062-1070.

Schroeder, K., Fahey, T., and Ebrahim, S. (2004). How can we improve adherence to blood pressure–lowering medication in ambulatory care?: systematic review of randomized controlled trials. Archives of Internal Medicine, 164(7), 722-732.

Shubber, Z., Mills, E. J., Nachega, J. B., Vreeman, R., Freitas, M., Bock, P., . . . Doherty, M. (2016). Patient-reported barriers to adherence to antiretroviral therapy: a systematic review and meta-analysis. PLoS medicine, 13(11), e1002183.

Simpson, S. H., Eurich, D. T., Majumdar, S. R., Padwal, R. S., Tsuyuki, R. T., Varney, J., and Johnson, J. A. (2006). A meta-analysis of the association between adherence to drug therapy and mortality. Bmj, 333(7557), 15.

Sokol, M. C., McGuigan, K. A., Verbrugge, R. R., and Epstein, R. S. (2005). Impact of medication adherence on hospitalization risk and healthcare cost. Medical care, 521-530.

Svarstad, B. L., Chewning, B. A., Sleath, B. L., and Claesson, C. (1999). The Brief Medication Questionnaire: a tool for screening patient adherence and barriers to adherence. Patient education and counseling, 37(2), 113-124.

Thiele, H., Zeymer, U., Neumann, F.-J., Ferenc, M., Olbrich, H.-G., Hausleiter, J., . . . Fuernau, G. (2012). Intraaortic balloon support for myocardial infarction with cardiogenic shock. New England journal of medicine, 367(14), 1287-1296.

Truong, H.-A., Groves, C. N., Congdon, H. B., Dang, D.-T. T., Botchway, R., and Thomas, J. (2015). Potential cost savings of medication therapy management in safety-net clinics. Journal of the American Pharmacists Association, 55(3), 269-272.

Williams, M. V., Parker, R. M., Baker, D. W., Parikh, N. S., Pitkin, K., Coates, W. C., and Nurss, J. R. (1995). Inadequate functional health literacy among patients at two public hospitals. Jama, 274(21), 1677-1682.

Wong, M., Jiang, J., and Griffiths, S. (2010). Factors associated with antihypertensive drug compliance in 83 884 Chinese patients: a cohort study. Journal of Epidemiology and Community Health, 64(10), 895-901.