Improving A Patient 's Medical Adherence

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The World Health Organization (WHO) defines adherence as “the extent to which a person’s behaviour – taking medication, following a diet, and/or executing lifestyle changes, corresponds with agreed recommendations from a health care provider. 1” Improving a patient’s medical adherence requires effort from healthcare staff from multi-disciplinary. This report will focus on improving medication adherence in a pharmacy setting.
Medication adherence is one of the obstacles to achieving desired clinical outcomes. Not only would nonadherence potentially harm an individual’s health, it also causes a huge financial burden on the NHS. The overall NHS expenditure on medicines in 2013-2014 was £14.4 billion, where the cost for drugs prescribed in hospitals and dispensed in the community was £159.6 million 2. A report published in 2005 suggests that between a half and third of all medicines prescribed for long term conditions are not taken as recommended 3. Unused or unwanted medicines cost NHS around £300 million annually 4. If the fees for hospital admissions due to medication nonadherence is added, the cost for the NHS will be even greater.
WHO has identified the need to address problems with medication adherence in patients with chronic illnesses. In the same report, WHO has also revealed the severity of medication nonadherence to antihypertensive treatments. Less than half of patients with hypertension in developing countries adhere to their antihypertensive drugs. Even in the United States, a developed country, only 51% of the hypertensive patients adhere to the prescribed treatments 1. It is likely that these patients developed nonadherence in their medications within the first two years of treatment. In a study conducted in Sweden o...

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...velop new and better interventions and ways to measure adherence by using more advanced research12.
In order to address the problems with the current intervention methods, the new health intervention will use the Theoretical Domains Framework (TDF), a framework derived from 33 psychological theories 13. It consists of 14 domains from psychological and organisational theory which influences behaviour change. An article published by BioMed Central (BMC) suggests that TDF shows usefulness in a wide range of clinical quality interventions as each of the 14 domains can play a relevant role in the interventions 14. Out of these 14 domains, BMC proposes that eight domains could positively influence patients’ behaviours: knowledge, skills, beliefs about capability, beliefs about consequences, motivation, social influences, behavioural regulation and nature of behaviours 13.

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