32
views
0
recommends
+1 Recommend
1 collections
    0
    shares

      Patient Preference and Adherence (submit here)

      This international, peer-reviewed Open Access journal by Dove Medical Press focuses on the growing importance of patient preference and adherence throughout the therapeutic process. Sign up for email alerts here.

      34,896 Monthly downloads/views I 2.314 Impact Factor I 3.8 CiteScore I 1.14 Source Normalized Impact per Paper (SNIP) I 0.629 Scimago Journal & Country Rank (SJR)

      • Record: found
      • Abstract: found
      • Article: found
      Is Open Access

      Definitions, variants, and causes of nonadherence with medication: a challenge for tailored interventions

      review-article

      Read this article at

      ScienceOpenPublisherPMC
      Bookmark
          There is no author summary for this article yet. Authors can add summaries to their articles on ScienceOpen to make them more accessible to a non-specialist audience.

          Abstract

          Background

          Nonadherence with medication is a complex and multidimensional health care problem. The causes may be related to the patient, treatment, and/or health care provider. As a consequence, substantial numbers of patients do not benefit optimally from pharmacotherapy, resulting in increased morbidity and mortality as well as increased societal costs. Several interventions may contribute to improved adherence. However, most interventions have only a modest effect. Thus, despite the many efforts made, there has been little progress made as yet in tackling the problem of nonadherence.

          Methods

          This paper summarizes the definitions and taxonomy of adherence with medication, as well as types and causes of nonadherence. In addition, interventions aimed at improvement of adherence are discussed.

          Conclusion

          There is not just one solution for the nonadherence problem that fits all patients. Most interventions to improve adherence are aimed at all patients regardless of whether they are adherent or not. Recently, a number of tailored interventions have been described in the literature. Modern techniques are useful. Electronic pill boxes combined with Short Message Service reminders are specifically designed to improve unintentional adherence and have resulted in an increase in refill adherence in diabetic patients with suboptimal adherence. Tailored Internet interventions are a possibility for influencing patient drug-taking behavior and show promising results. Tailored counseling interventions targeted at the underlying causes of nonadherence seem an attractive method for supporting patients with their use of drugs. However, despite the plausible theoretical framework, data on long-term health effects of the various interventions are not available. To improve adherence effectively, there is a need for a tailored approach based on the type and cause of nonadherence and the specific needs of the patient.

          Most cited references43

          • Record: found
          • Abstract: not found
          • Article: not found

          Adherence to long-term therapies: evidence for action.

            Bookmark
            • Record: found
            • Abstract: found
            • Article: not found

            Impact of medication adherence on hospitalization risk and healthcare cost.

            The objective of this study was to evaluate the impact of medication adherence on healthcare utilization and cost for 4 chronic conditions that are major drivers of drug spending: diabetes, hypertension, hypercholesterolemia, and congestive heart failure. The authors conducted a retrospective cohort observation of patients who were continuously enrolled in medical and prescription benefit plans from June 1997 through May 1999. Patients were identified for disease-specific analysis based on claims for outpatient, emergency room, or inpatient services during the first 12 months of the study. Using an integrated analysis of administrative claims data, medical and drug utilization were measured during the 12-month period after patient identification. Medication adherence was defined by days' supply of maintenance medications for each condition. The study consisted of a population-based sample of 137,277 patients under age 65. Disease-related and all-cause medical costs, drug costs, and hospitalization risk were measured. Using regression analysis, these measures were modeled at varying levels of medication adherence. For diabetes and hypercholesterolemia, a high level of medication adherence was associated with lower disease-related medical costs. For these conditions, higher medication costs were more than offset by medical cost reductions, producing a net reduction in overall healthcare costs. For diabetes, hypercholesterolemia, and hypertension, cost offsets were observed for all-cause medical costs at high levels of medication adherence. For all 4 conditions, hospitalization rates were significantly lower for patients with high medication adherence. For some chronic conditions, increased drug utilization can provide a net economic return when it is driven by improved adherence with guidelines-based therapy.
              Bookmark
              • Record: found
              • Abstract: found
              • Article: not found

              A meta-analysis of the association between adherence to drug therapy and mortality.

              To evaluate the relation between adherence to drug therapy, including placebo, and mortality. Meta-analysis of observational studies. Electronic databases, contact with investigators, and textbooks and reviews on adherence. Review methods Predefined criteria were used to select studies reporting mortality among participants with good and poor adherence to drug therapy. Data were extracted for disease, drug therapy groups, methods for measurement of adherence rate, definition for good adherence, and mortality. Data were available from 21 studies (46,847 participants), including eight studies with placebo arms (19,633 participants). Compared with poor adherence, good adherence was associated with lower mortality (odds ratio 0.56, 95% confidence interval 0.50 to 0.63). Good adherence to placebo was associated with lower mortality (0.56, 0.43 to 0.74), as was good adherence to beneficial drug therapy (0.55, 0.49 to 0.62). Good adherence to harmful drug therapy was associated with increased mortality (2.90, 1.04 to 8.11). Good adherence to drug therapy is associated with positive health outcomes. Moreover, the observed association between good adherence to placebo and mortality supports the existence of the "healthy adherer" effect, whereby adherence to drug therapy may be a surrogate marker for overall healthy behaviour.
                Bookmark

                Author and article information

                Journal
                Patient Prefer Adherence
                Patient Prefer Adherence
                Patient preference and adherence
                Dove Medical Press
                1177-889X
                2013
                10 July 2013
                : 7
                : 675-682
                Affiliations
                [1 ]EMGO+ Institute and Department of Clinical Pharmacology and Pharmacy, VU University Medical Center, Amsterdam
                [2 ]ANH-VUmc, VU University Medical Center, Amsterdam
                [3 ]NIVEL, Netherlands Institute for Health Services Research, Utrecht, The Netherlands
                Author notes
                Correspondence: Jacqueline G Hugtenburg, Department of Clinical Pharmacology and Pharmacy, VU University Medical Center, De Boelelaan 1117, 1081 HV Amsterdam, The Netherlands, Tel +31 20 444 3524, Fax +31 20 444 3525, Email jg.hugtenburg@ 123456vumc.nl
                Article
                ppa-7-675
                10.2147/PPA.S29549
                3711878
                23874088
                620522f3-87ea-45e9-a0af-8b3ce6075771
                © 2013 Hugtenburg et al, publisher and licensee Dove Medical Press Ltd

                This is an Open Access article which permits unrestricted noncommercial use, provided the original work is properly cited.

                History
                Categories
                Review

                Medicine
                adherence,compliance,concordance,tailored intervention
                Medicine
                adherence, compliance, concordance, tailored intervention

                Comments

                Comment on this article