Medication Non-Adherence in Chronic Diseases: Causes & Consequences - Essay Sample

Introduction

Despite the tremendous benefits of adherence, medication non-adherence is a significant problem among patients with multiple chronic diseases, including hypertension and diabetes. According to the World Health Organisation (WHO), the rate of non-adherence is recorded at 50% among people with chronic disease. Its consequences include increased comorbid illness, worsening condition, increased cost of health, and possible death occurrence (World Health Organization, 2015). Based on patient factors that may affect medication adherence, patients who receive social support from caregivers, families, or friends often demonstrate better adherence to medication (Deravin & Anderson, 2016). Simultaneously, lack of finance, limited access to care, and increased cost of treatment are all linked to non-adherence (Haley, 2015). Also, the relationship between the patient and the health care provider is another significant factor; for example, a good relationship that involves reinforcement and encouragement from the doctor show positive impact on adherence, while poor relationship indicates a negative impact on adherence (Holland et al., 2019) . Notably, long term medication usually shows a decline in medication adherence as well as the complexity of the treatment regime. And, patient-related factors including cognitive limitations and impairment (Tobiano et al., 2016).

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Regarding the strategies to overcome patient-initiated barriers to improve medication adherence, setting up reminders for patients with chronic diseases can help improve medication adherence (Weeks et al., 2016). It helps patients to remember when to take drugs and how to manage their medication (Chang & Johnson, 2018). Also, identifying cost-cutting strategies through medication subsidies can assist in improving medication adherence for such patients. Additionally, care managers and clinicians should provide support to the patients through lowering the copayments (Neiman et al., 2017). And addressing mental disorders and stigma, especially for adult patients, is another strategy that can help improve medication adherence for patients with multiple chronic diseases (Brummel & Carlson, 2016). Overcoming mental impairment and the stigma associated can be implemented through motivational interviews and coaching such patients.

Nurses should ensure that the setup reminders conform to the doctor’s prescription and the right interval for taking medication based on how registered nurses can evaluate the techniques for overcoming patient-initiated barriers (Levett-Jones, 2018). On cost-cutting strategies, nurses should ensure that medical subsidies are provided, especially to the patients who cannot afford the standard medication (Choudhry et al., 2017). And psychiatric nurses should ensure that patients with mental disorders receive mental therapy to overcome the stigma, thereby, improving medication adherence.

Concerning health care provider factors that can affect medication adherence, patient-physician relationships play a critical role in determining medication adherence in patients with multiply chronic diseases (Larsen & Lubkin, 2019). Patients who are happy with the way their doctors communicated with them tend to show a positive response to medication adherence. Another factor includes patient involvement and participation in decision making; thus, it is true that the engagement of patients in decision-making processes for their treatment enhances medication adherence (Lee et al., 2017). Detailed information and complex prescription provided by the doctor to the patient also affect medication adherence. The most suitable way for doctors to facilitate patients’ engagement in health care varies across cultures.

On overcoming health care provider initiated barriers, proper communication between doctors and patients help improve medication adherence because they feel motivated by their health care providers (Thakkar et al., 2016). Patients should be engaged as they participate in decision making regarding their medication and be informed about the consequences of non-adherence (Lauffenburger et al., 2017). Doctors should ensure that their prescriptions are simple to understand. In evaluating the efficacy of the techniques, registered nurses should assess the communication’s effectiveness between the doctor and the patient (Australian Institute of Health and Welfare, 2018). The evaluation focuses on the sufficiency of patients’ involvement and how they participate in making medication decisions (Yap et al., 2016). They should assess the prescriptions to ensure patients understand the doctor’s information.

References

Australian Institute of Health and Welfare. (2018) Australian Health 2018. Retrieved from https://www.aihw.gov.au/

Brummel, A., & Carlson, A. M. (2016). Comprehensive medication management and medication adherence for chronic conditions. Journal of Managed Care & Specialty Pharmacy, 22(1), 56-62.

Chang, E., & Johnson, A. (2018). Living with Chronic Illness and Disability. Principles for Nursing Practice (3rd ed.). Sydney: Elsevier Australia.

Choudhry, N. K., Krumme, A. A., Ercole, P. M., Girdish, C., Tong, A. Y., Khan, N. F., ... & Franklin, J. M. (2017). Effect of reminder devices on medication adherence: the REMIND randomized clinical trial. JAMA internal medicine, 177(5), 624-631.

Deravin, L., & Anderson, J. (2016). Chronic Care Nursing: A framework for Practice. Port Melbourne, VIC: Cambridge University Press.

Haley, C. (Ed.). (2015). Pillitteri’s child and family health nursing in Australia and New Zealand (2nd ed.). North Ryde, N.S.W.: Wolters Kluwer.

Holland, K., Jenkins, J., Solomon, J., & Whittam, S. (2019). Applying the Roper-Logan-Tierney Model in Practice (3rd ed.). London: Churchill Livingston.

Larsen, P. D., & Lubkin, I. M. (2019). Chronic Illness: Impact and Intervension (10th ed.). Sudbury, Massachusetts: Jones and Bartlett.

Lauffenburger, J. C., Shrank, W. H., Bitton, A., Franklin, J. M., Glynn, R. J., Krumme, A. A., ... & Choudhry, N. K. (2017). Association between patient-centered medical homes and adherence to chronic disease medications: a cohort study. Annals of Internal Medicine, 166(2), 81-88.

Lee, Y. M., Yu, H. Y., You, M. A., & Son, Y. J. (2017). Impact of health literacy on medication adherence in older people with chronic diseases. Collegian, 24(1), 11-18.

Levett-Jones, T. (2018). Clinical Reasoning : Learning to Think like a nurse (2nd ed.). Frenchs Forest, N.S.W.: Pearson.

Neiman, A. B., Ruppar, T., Ho, M., Garber, L., Weidle, P. J., Hong, Y., ... & Thorpe, P. G. (2017). CDC grand rounds: improving medication adherence for chronic disease management—innovations and opportunities. MMWR. Morbidity and mortality weekly report, 66(45), 1248.

Thakkar, J., Kurup, R., Laba, T. L., Santo, K., Thiagalingam, A., Rodgers, A., ... & Chow, C. K. (2016). Mobile telephone text messaging for medication adherence in chronic disease: a meta-analysis. JAMA internal medicine, 176(3), 340-349.

Tobiano, G., Bucknall, T., Marshall, A., Guinane, J., & Chaboyer, W. (2016). Patients’ perceptions of participation in nursing care on medical wards. Scandinavian Journal of Caring Sciences, 30(2), 260-270.

Weeks, G., George, J., Maclure, K., & Stewart, D. (2016). Nonmedical prescribing versus medical prescribing for acute and chronic disease management in primary and secondary care. Cochrane Database of Systematic Reviews, (11).

World Health Organization. (2015). Non Communicable Diseases. Retrieved from https://onlinelibrary.wiley.com/doi/abs/10.1111/j.1728-4457.2015.00070.x

Yap, A. F., Thirumoorthy, T., & Kwan, Y. H. (2016). Medication adherence in the elderly. Journal of Clinical Gerontology and Geriatrics, 7(2), 64-67.