According to the World Health Organization, adherence is defined as:
"The degree to which the person’s behavior corresponds with the agreed recommendations from a health care provider” [1].
Adherence to certain therapies, such as medications, enables successful treatment of medical conditions. Nonadherence to medications has the potential to result in negative health outcomes. There are a variety of factors that can affect adherence. The medication taking behaviour of patients is complex. Therefore, identifying specific barriers to adherence is important to improve a patient’s health outcomes.
Nonadherence can be intentional or unintentional. Intentional adherence is when the patient actively decides to not take their medications as prescribed or not take them at all [2]. Some factors that may contribute to intentional nonadherence is the patient’s lack of motivation to persist with the treatment, or their personal belief and attitude towards the treatment itself. Unintentional adherence is when the patient does not take their medications as recommended but this is a passive and unplanned process [3]. Some factors that may contribute to unintentional nonadherence is that the patient has trouble remembering to take their doses, problems accessing their medications at the pharmacy, the individual’s physical constraints, etc. Meanwhile over-adherence refers to when the patient takes more medications than recommended, whether that be actively or passively [4]. Understanding if a patient’s nonadherence is intentional or unintentional can help better drive accurate solutions for the particular patient.
The reason why finding solutions to help solve a patient’s nonadherence to medications is so important is because nonadherence can lead to negative health outcomes. Studies have shown that there is a higher risk of hospitalization for patients with chronic diseases who are non-adherent to their prescribed therapies [3]. Along with that, nonadherence also leads to a wastage of medication resources. At the Patel Research Lab we hope to better understand medication adherence behaviour among patients through our research with the goal of finding solutions to these problems.
References:
World Health Organization. Adherence to long-term therapies: evidence for action. Geneva, Switzerland: WHO; 2003Brown, M. T., & Bussell, J. K. (2011). Medication adherence: WHO cares?. Mayo Clinic proceedings, 86(4), 304–314. https://doi.org/10.4065/mcp.2010.0575
Hugtenburg JG, Timmers L, Elders PJM, et al. Definitions, variants and causes of nonadherence with medications: a challenge for tailored interventions. Patient Pref Adhere 2013;7:675-82.
Fuso L, Incalzi RA, Pistelli R, Muzzolon R, Valente S, Pagliari G, et al. Predicting mortality of patients hospitalized for acutely exacerbated chronic obstructive pulmonary disease. Am J Med 1995. Mar;98(3):272-277 10.1016/S0002-9343(99)80374-X
Patel, T. (2021). Medication nonadherence: Time for a proactive approach by pharmacists. Canadian Pharmacists Journal / Revue Des Pharmaciens Du Canada, 154(5), 292–296. https://doi.org/10.1177/17151635211034216