Compliance, Concordance and Adherence

National Institute for Health and Care Excellence (NICE) Guidance > Medicines adherence: involving patients in decisions about prescribed medicines and supporting adherence

This guideline covers medicines adherence in people aged 18 and over. It recommends how to encourage adherence to medicines by supporting and involving people in decisions about their prescribed medicines. It aims to ensure that a person’s decision to use a medicine is an informed choice.

  • Source: nice.org.uk
  • Pharmacy Resource: Guidance
  • Register to Access Content: No

National Institute for Health and Care Excellence (NICE) Guidance > Medicines optimisation: the safe and effective use of medicines to enable the best possible outcomes

This guideline covers safe and effective use of medicines in health and social care for people taking 1 or more medicines. It aims to ensure that medicines provide the greatest possible benefit to people by encouraging medicines reconciliation, medication review, and the use of patient decision aids.

  • Source: nice.org.uk
  • Pharmacy Resource: Guidance
  • Register to Access Content: No

Royal Pharmaceutical Society Guide: Medicines Adherence

The purpose of this guidance is to help pharmacists to support patients to get involved in decision making regarding the medicines they take, improve adherence and contribute to strengthening lines of communication between healthcare professionals.

  • Source: rpharms.com
  • Pharmacy Resource: Guide
  • Register to Access Content: Yes – content available to members of the RPS

Adherence to treatment and developing concordance skills

Find out more information about ‘adherence to treatment and developing concordance skills’ by using the eLearning materials for ‘introduction to concordance and adherence to treatment’, ‘involving patients in treatment decisions’, and ‘concordance consultation skills’ and/or the other useful links and resources available on the left-hand side menu in each of these areas.

  • Source: webarchive.org.uk
  • Pharmacy Resource: e-Learning
  • Register to Access Content: No

Assessing and improving adherence to prescribed medicines

Find out more information about ‘assessing and improving adherence to prescribed medicines’ by using the eLearning materials for ‘assessing adherence to treatment’, and ‘interventions to increase adherence to prescribed medicines’ and/or the other useful links and resources available on the left-hand side menu in both of these areas.

  • Source: webarchive.org.uk
  • Pharmacy Resource: e-Learning
  • Register to Access Content: No

Medication Compliance and Persistence: Terminology and Definitions

The aim of the study is to provide guidance regarding the meaning and use of the terms “compliance” and “persistence” as they relate to the study of medication use.

  • Source: ispor.org
  • Pharmacy Resource: Journal Article
  • Register to Access Content: No

The Pharmacist’s Role in Medication Adherence

Medication adherence is the voluntary cooperation of the patient in taking drugs or medicine as prescribed, including timing, dosage, and frequency. The term concordance, which has developed over the past decade, is based on the patient-centered philosophy that the patient and the health care provider (HCP) play equal roles in medication decision-making.

  • Source: uspharmacist.com
  • Pharmacy Resource: Journal Article
  • Register to Access Content: No

Using Theory to Explore the Determinants of Medication Adherence; Moving Away from a One-Size-Fits-All Approach

This commentary re-visits the call for adherence interventions to be tailored to meet individual need, by considering what this means for day-to-day practice and how this can be achieved. It provides an update on advances in psychological theory to identify the root cause of an individual’s non-adherence to encourage matching of provided adherence support. It also provides a practical perspective by considering exemplars of innovative practice and evaluating the day-to-day practicalities of taking a novel approach.

  • Source: mdpi.com
  • Pharmacy Resource: Journal Article
  • Register to Access Content: No

A competency framework for shared decision-making with patients
Achieving concordance for taking medicines
First Edition

This framework has been produced by the Medicines Partnership Programme at NPC Plus.

This document sets out good practice for health and social care professionals in their consultations with patients about their healthcare and treatment. It describes the skills and behaviours that practitioners need to ensure that they listen effectively to patients. The competency framework will also help them to respect diversity and patient beliefs and work with patients to reach a shared agreement about treatment where this is possible.

It is intended to be used by healthcare professionals wherever healthcare is provided. Involvement in care and treatment decisions is important for all patients; for those with long term conditions as their care is ongoing and also for those with acute episodes of ill-health.

  • Source: webarchive.org.uk
  • Pharmacy Resource: Competency Framework
  • Register to Access Content: No

Managing and Supporting Medication Adherence
A framework for the education and training of health professionals in Europe

The educational framework presented is principally aimed at the professions of medication, pharmacy and nursing in Europe, but also applies to any health professional engaging in discussions with patients about their medications.

  • Source: abcproject.eu
  • Pharmacy Resource: Framework
  • Register to Access Content: No

Closing the Quality Gap Series: Medication Adherence Interventions: Comparative Effectiveness
Agency for Healthcare Research and Quality

This review seeks to synthesize evidence regarding the efficacy and effectiveness of interventions to improve medication adherence among adults across a broad array of chronic conditions.

  • Source: effectivehealthcare.ahrq.gov
  • Pharmacy Resource: Report
  • Register to Access Content: No

Ascertaining Barriers for Compliance: policies for safe, effective and cost-effective use of medicines in Europe

Research results unequivocally point at non-compliance as a major barrier to realise the benefits of evidence-based treatments, both in the case of long-term treatment, as well as short-term medication, e.g. antimicrobial therapy. The lower the compliance, the poorer the outcomes, and the less cost- effective treatments become. Moreover, non-compliance is accompanied with increased health services utilisation, and increased healthcare expenditures.

  • Source: abcproject.eu
  • Pharmacy Resource: Report
  • Register to Access Content: No

Patient Compliance and Health Behavior Models

Compliance is the process whereby the patient follows the prescribed and dispensed regimen as intended by the prescriber and dispenser. It is defined as “the extent to which a person’s behavior (in terms of taking medications, following diets, or executing lifestyle changes) coincides with medical or health advice.”

  • Source: uspharmacist.com
  • Pharmacy Resource: Journal Article
  • Register to Access Content: No

Medicines Optimisation: Helping patients to make the most of medicines

This good practice guidance provides four guiding principles for medicines optimisation that will help all healthcare professionals to support patients to get the best outcomes from their medicines use.

  • Source: rpharms.com
  • Pharmacy Resource: Guidance
  • Register to Access Content: No

Adult Meducation

The American Society on Aging (ASA) and the American Society of Consultant Pharmacists (ASCP) Foundation have collaborated on the development of Adult Meducation: Improving Medication Adherence in Older Adults, a web-based program to educate ASA and ASCP members on important aspects of medication adherence in older adults.

This website contains:

  • Information on factors that influence medication adherence, barriers to adherence, and specific strategies to improve adherence
  • Tools to identify older adults at risk for medication nonadherence
  • Resources to improve medication adherence
  • Materials to educate older adults about the importance of medication adherence
  • Educational programs targeted at community-based service providers and health professionals
  • Links to other useful web resources.
  • Source: adultmeducation.com
  • Pharmacy Resource: Various
  • Register to Access Content: No

Adherence to Long-Term Therapies: Evidence for Action

This report is part of the work of the Adherence to Long-term Therapies Project, a global initiative launched in 2001 by the Noncommunicable Diseases and Mental Health Cluster of the World Health Organization.

The main target audience for this report are policy-makers and health managers who can have an impact on national and local policies in ways that will benefit patients, health systems and societies with better health outcomes and economic efficiency. This report will also be a useful reference for scientists and clinicians in their daily work.

The main objective of the project is to improve worldwide rates of adherence to therapies commonly used in treating chronic conditions.

  • Source: who.int
  • Pharmacy Resource: Report
  • Register to Access Content: No

“Medication Adherence”

Poor adherence affects both men and women of all ages and socioeconomic groups. As the nation continues to age, the risk of poor adherence in the elderly has become a significant concern. This group of Americans accounts for 30% for all prescription medications purchased. The regimens they take are often complex and confusing. The report also indicated that medication adherence is much higher in individuals with acute conditions compared to chronic diseases. This lesson will focus on strategies to improve adherence in chronic disease.

“Adherence Part 2: Pharmacist’s Perspective”

Poor adherence to medical therapies compromises patient outcomes. According to the WHO, improving adherence to medical therapy for hypertension, hyperlipidemia, and diabetes would result in significant health and economic benefit.

  • Source: wfprofessional.com
  • Pharmacy Resource: CE / CPD / Learning
  • Register to Access Content: No

Putting concordance into practice: core consulting skills

Wendy Clyne and David Colin-Thome discuss how concordance in medicine-taking can be achieved by applying core clinical skills

Ambivalence about medicines and how to deal with it

Wendy Clyne discusses ways to resolve medicines ambivalence to achieve concordance

Achieving concordance through use of decision-support tools

Wendy Clyne and Steve Chapman describe how decision-support tools can aid concordance

  • Source: eu.wiley.com
  • Pharmacy Resource: Journal Articles
  • Register to Access Content: No

Thinking Outside the Pillbox: A System-wide Approach to Improving Patient Medication Adherence for Chronic Disease

This issue brief addresses the root causes of poor patient medication adherence – a significant contributor to overall health care waste – and offers promising solutions to improve adherence, particularly among chronic disease patients.

  • Source: nehi-us.org
  • Pharmacy Resource: Publication
  • Register to Access Content: No

Concordance, adherence and compliance in medicine taking

This report is a product of a scoping exercise commissioned by the NHS National Coordinating Centre for Service Delivery and Organisation (NCCSDO) with the following aims:

  1. Summarise current knowledge about the determinants of medication-taking.
  2. Construct a conceptual map of the area of compliance, adherence and concordance.
  3. Identify priorities for future research of relevance to the NHS, with particular emphasis on identifying what new knowledge is needed to be able to develop effective, realisable, efficient and equitable interventions to promote the appropriate use of medicines for the benefit of patients and the NHS.

The scoping exercise involved analysis of the literature, a listening exercise involving consultation with both a user group and with a group of academics, health care professionals and managers, plus feedback from an Expert Panel.

  • Source: nihr.ac.uk
  • Pharmacy Resource: Report
  • Register to Access Content: No

The Unhidden Cost of Noncompliance

Learning Objectives

After completing this activity, the participant should be better able to

  1. Describe the clinical and economic impact related to noncompliance within the managed health care setting.
  2. Explain methods, such as motivational interviewing techniques, for improving overall compliance to therapies.
  3. Specify current strategies to optimize the use of medication therapy management programs.
  4. Identify collaborative approaches that maximize available resources to improve treatment compliance outcomes.
  • Source: amcp.org
  • Pharmacy Resource: Supplement
  • Register to Access Content: No

Medication Adherence: WHO Cares?

This review will discuss general aspects of medication adherence, using cardiovascular disease (CVD) as an example, and provide the physician with various practical strategies and resources for improving medication adherence among their patients.

  • Source: mayoclinicproceedings.org
  • Pharmacy Resource: Journal Article
  • Register to Access Content: No

Improving Patient Medication Adherence: Key Issues and Challenges in Daily Practice of Medicine

This issue brief discusses how evolving models of medication management are key to bringing improved medication adherence, and thus improved patient outcomes and reduced costs, into the daily practice of medicine.

  • Source: nehi-us.org
  • Pharmacy Resource: Brief
  • Register to Access Content: No

Overcoming Barriers to Medication Adherence for Chronic Diseases

Join our speakers as they discuss research, interventions, education, and emerging tools and technologies that may help overcome these barriers to medication non-adherence.

  • Source: cdc.gov
  • Pharmacy Resource: Various
  • Register to Access Content: No

Reducing Hospital Readmissions Through Medication Management and Improved Patient Adherence

NEHI (The Network for Excellence in Health Innovation), the Anthem Foundation, Anthem Blue Cross in California and Anthem Blue Cross Blue Shield (BCBS) in Connecticut partnered on this project to provide an in-depth assessment of policies and practices already in use that could be used to create a national strategy for reducing preventable hospital readmissions through improved medication management and better patient medication adherence.

  • Source: nehi-us.org
  • Pharmacy Resource: Report
  • Register to Access Content: No

Still Paying the Price: Prescription Charges and People with Long-Term Conditions
A report by the Prescription Charges Coalition

The Prescription Charges Coalition brings together more than 40 organisations concerned with the impact that prescription charges are having on working-age people with long-term conditions in England.

Previous research undertaken by the Coalition demonstrated that prescription charges have a significant negative impact on medicine adherence, self-management, quality of life and health outcomes for people with long-term conditions, with knock-on effects on their ability to secure and retain suitable employment . Our latest research builds on this evidence and shows that working-age people with longterm conditions in England continue to suffer as a result of an outdated system that urgently needs reform.

  • Source: prescriptionchargescoalition.org.uk
  • Pharmacy Resource: Report
  • Register to Access Content: No

Clinical and Economic Advantages of Modern Dosage Forms: Improving Medication Adherence

This paper examines a substantial source of waste and inefficiency in health care: patient nonadherence with medications. The authors explain how modern drug delivery technology can improve adherence by simplifying the dosage regimen, and/or decreasing side effects.

  • Source: npcnow.org
  • Pharmacy Resource: Publication
  • Register to Access Content: No

Drug Delivery Systems Improve Pharmaceutical Profile and Facilitate Medication Adherence

This paper delves into the issues surrounding drug delivery, and how modern medicine has continually improved how we deliver medicines to patients. The authors discuss how innovations in dosage forms and dose delivery systems across a wide range of medications offer substantial clinical advantages, including reduced dosing frequency and improved patient adherence; minimized fluctuation of drug concentrations and maintenance of blood levels within a desired range; localized drug delivery; and the potential for reduced adverse effects and increased safety.

  • Source: npcnow.org
  • Pharmacy Resource: Publication
  • Register to Access Content: No

Counselling, Concordance, and Communication

This booklet is intended to be used as a handbook or guide to the knowledge and skills required in patient counselling in different settings. Additionally, it includes both research-based information and practical tips on providing medicines information services and learning patient counselling skills.

This booklet is targeted to a wide range of pharmacy professionals, such as pharmacy students, recent graduates, pharmacy practice professionals, pharmaceutical societies/organisations and key stakeholders involved in the design of pharmacy curricula and continuing education for practitioners.

  • Source: fip.org
  • Pharmacy Resource: Booklet
  • Register to Access Content: No

Medication adherence: patient education, communication and behaviour

The goals of this article are to address (1) the reasons for non-adherence, (2) the prevalence of medication non-adherence, (3) the consequences of non-adherence, (4) patient behaviour with respect to taking medications and finally, (5) interventions to improve medication adherence.

  • Source: um.edu.mt
  • Pharmacy Resource: Journal Article
  • Register to Access Content: No

The Cochrane Collaboration
Cochrane Reviews – Consumer & Communication Strategies

The Cochrane Collaboration is an international, non-profit, independent organisation, established to ensure that up-to-date, accurate information about the effects of healthcare interventions is readily available worldwide. It produces and disseminates systematic reviews of healthcare interventions, and promotes the search for evidence in the form of clinical trials and other studies of the effects of interventions.

  • Source: cochrane.org
  • Pharmacy Resource: Systematic Reviews
  • Register to Access Content: No

I’ve missed a dose; what should I do?

More than 80% of patients occasionally miss a dose of their medication. Health practitioners ought to plan with their patients what to do if a dose is missed. Patients believe that this plan should be a required part of the information received when a medication is prescribed and dispensed.

  • Source: nps.org.au
  • Pharmacy Resource: Journal Articl
  • Register to Access Content: No

Health Literacy
Report from an RCGP-led health literacy workshop

Research highlighted by the RCGP shows how 43% of UK adults fail to fully understand information that contains text, such as signs in hospital, leaflets and health guides, while one in three adults fails to understand numerical information presented to them.

Health professionals can sometimes overestimate the health literacy of their patients, and patients can feel too embarrassed to ask questions. In addition, doctors often supplement verbal information with a leaflet, presuming that it can be read. This can lead to distress and a lack of understanding for patients.

  • Source: rcgp.org.uk
  • Pharmacy Resource: Report
  • Register to Access Content: No

Health Literacy Measurement Tools (Revised)

Health literacy is the degree to which individuals have the capacity to obtain, process, and understand basic health information and services needed to make appropriate health decisions.

The tools available from AHRQ are the:

  • Short Assessment of Health Literacy–Spanish and English
  • Rapid Estimate of Adult Literacy in Medicine–Short Form
  • Short Assessment of Health Literacy for Spanish Adults
  • Source: ahrq.gov
  • Pharmacy Resource: Tools
  • Register to Access Content: No

Alphabetical Glossary of Animal Substances

  • Source: viva.org.uk
  • Pharmacy Resource: Factsheet
  • Register to Access Content: No

Choosing a calcium and vitamin D preparation for vegetarians or vegans

This article explains how the source of vitamin D, or the inactive ingredients (excipients), may make preparations unsuitable for vegetarians or vegans.

  • Source: sps.nhs.uk
  • Pharmacy Resource: Article
  • Register to Access Content: No

GP guide to managing patients who wish to fast during Ramadan

This article considers the advice that patients should receive before they take the decision to fast during Ramadan and how their dosage regimens may need to be modified.

  • Source: eu.wiley.com
  • Pharmacy Resource: Journal Article
  • Register to Access Content: No

Optimising Medicines Use During Ramadan Films

Community Pharmacy West Yorkshire have produced three films on optimising medicines use during Ramadan. The aim is to help address how community pharmacy teams can support patients to use their medicines and promote health and wellbeing during Ramadan.

Helping pharmacy teams support patients during the Holy Month of Ramadan

Medicines use during the Holy Month of Ramadan – Information for pharmacy teams

Medicines use during the Holy Month of Ramadan – Information for patients

  • Source: cpwy.org
  • Pharmacy Resource: Videos
  • Register to Access Content: No

Ramadan and your Diabetic patient: A resource pack for Healthcare Professionals

  • Source: nhsggc.org.uk
  • Pharmacy Resource: Resource Pack
  • Register to Access Content: No

Recommendations for Management of Diabetes During Ramadan

In this revised document, we continue to avoid use of the terms “indications” or “contraindications” for fasting because fasting is a spiritual issue for which patients make their own decision after receiving appropriate advice from religious teachings and from health care providers. However, we emphasize that fasting, especially among patients with type 1 diabetes with poor glycemic control, is associated with multiple risks.

  • Source: care.diabetesjournals.org
  • Pharmacy Resource: Journal Article
  • Register to Access Content: No

Medication Adherence: The Real Problem When Treating Chronic Conditions

When counseling about medication adherence for the three major disease states—diabetes, hypertension, and hyperlipidemia—it is important to educate the patient about the consequences of not appropriately treating these conditions, which can result in heart attack, heart failure, stroke, paralysis, and potentially permanent and devastating alterations to their quality of life. Pharmacists must paint a picture of the situation and remind patients why they are taking the medication in the first place.

  • Source: uspharmacist.com
  • Pharmacy Resource: Journal Article
  • Register to Access Content: No

Medication Adherence in Cardiovascular Disease

Patients with high adherence rates have a significantly lower risk of cardiovascular events compared with those with low adherence rates.

  • Source: ashjournal.com
  • Pharmacy Resource: Journal Article
  • Register to Access Content: No

American Society of Hypertension Position Paper: Adherence and Persistence With Taking Medication to Control High Blood Pressure

  • Source: ashjournal.com
  • Pharmacy Resource: Position Paper
  • Register to Access Content: No

Combination therapy in hypertension

It is within this context that the American Society of Hypertension presents this Position Paper on Combination Therapy for Hypertension. It will address the scientific basis of combination therapy, present the pharmacologic rationale for choosing specific drug combinations, and review patient selection criteria for initial and secondary use. The advantages and disadvantages of single pill (fixed) drug combinations, and the implications of recent clinical trials involving specific combination strategies will also be discussed.

  • Source: ashjournal.com
  • Pharmacy Resource: Position Paper
  • Register to Access Content: No

European Society of Hypertension Newsletter
Patient Compliance in the Treatment of Arterial Hypertension

  • Source: eshonline.org
  • Pharmacy Resource: Newsletter
  • Register to Access Content: No

The Use of Single Pill Combination Treatments in Patients with Hypertension
Statement from the British Hypertension Society

“In view of the apparent benefits of fixed dose combinations over free-drug combinations, the BHS believes that if there are no significant cost disadvantages “fixed-drug” or single-pill combinations of drugs should be used preferentially for the routine management of hypertension when ≥ 2 drugs are required”.

  • Source: bihsoc.org
  • Pharmacy Resource: Statement
  • Register to Access Content: No

Predictive Validity of a Medication Adherence Measure in an Outpatient Setting

This study examines the psychometric properties and tests the concurrent and predictive validity of a structured, self-reported medication adherence measure in patients with hypertension.

  • Source: eu.wiley.com
  • Pharmacy Resource: Journal Article
  • Register to Access Content: No

Asthma Adherence
A Guide for Health Professionals

In developing this practical guide the National Asthma Council (NAC) aims to assist those involved in asthma care to understand more about adherence and the factors affecting it, both as a patient issue and an asthma management issue.

  • Source: nationalasthma.org.au
  • Pharmacy Resource: Guide
  • Register to Access Content: No

Better Use of Medicines for Diabetes Patients
5 Critical Ways to Improve Care

This paper describes five sets of challenges involving medications in diabetes care, and offers recommendations that could drive change.

  • Source: nehi-us.org
  • Pharmacy Resource: Publication
  • Register to Access Content: No

Improving Adherence in the Treatment of Type 2 Diabetes

This article will provide a succinct overview of the problem of nonadherence, an appraisal of its impact on the management of diabetes, and a common sense approach to improving compliance by choosing the medication most likely to promote adherence.

  • Source: uspharmacist.com
  • Pharmacy Resource: Journal Article
  • Register to Access Content: No

Improving Patient Adherence

This article reviews studies documenting the extent of and factors related to adherence problems among patients with diabetes. Recommendations are made for improving patient adherence, with an emphasis on adopting a collaborative model of care and skillful use of behavioral change strategies.

  • Source: clinical.diabetesjournals.org
  • Pharmacy Resource: Journal Article
  • Register to Access Content: No

Adherence to medication in epilepsy

Eminent Ambassador for Epilepsy, Professor Martin Brodie was the keynote speaker at Epilepsy Queensland’s Taking Charge Seminar, held during Epilepsy Awareness month. Martin Brodie is the Professor of Medicine and Clinical Pharmacology from the University of Glasgow Scotland. Below is a summary of his discussion concerning adherence to
antiepileptic medication.

  • Source: epilepsyaustralia.net
  • Pharmacy Resource: Summary
  • Register to Access Content: No

Missed Hormonal Contraceptives: New Recommendations

This committee opinion has been reviewed by the Social and Sexual Issues Committee and reviewed and approved by the Executive of the Society of Obstetricians and Gynaecologists of Canada.

  • Source: sogc.org
  • Pharmacy Resource: Commitee Opinion
  • Register to Access Content: No

Monitoring Opioid Adherence in Chronic Pain Patients: Tools, Techniques, and Utility

This paper provides a review of the numerous monitoring approaches that have been described in the literature and addresses the benefits and limitations of these techniques and tools. The complex nature of the problem of drug misuse and abuse is discussed, and while no single monitoring technique can fully address this complex issue, we describe how multiple approaches to adherence monitoring may be employed to sustain the prudent use of opioids for the treatment of chronic pain.

  • Source: painphysicianjournal.com
  • Pharmacy Resource: Journal Article
  • Register to Access Content: No

Compliance with treatment in osteoporosis patients

This article reviews the trends of compliance and persistence with bisphosphonate therapy in patients with osteoporosis in the ‘real world’ setting

  • Source: racgp.org.au
  • Pharmacy Resource: Journal Article
  • Register to Access Content: No

Using Bone Turnover Markers to Detect Low Adherence to Osteoporosis Treatment

  • Source: osteoporosis.foundation
  • Pharmacy Resource: Factsheet
  • Register to Access Content: No

 

Pharmacy Resources Last Checked: 01/10/2021

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