Medication adherence is important to achieve hypertension control for many patients. However, only 51% of Americans treated for hypertension actually follow their health care provider’s advice in terms of long-term medication therapy.
Adherence is key to success in controlling hypertension. Studies show that non-adherence to cardioprotective medications increases a patient’s risk of death from 50% to 80%.
As a health care professional, you can empower patients to take their medications as prescribed. Effective two-way communication is critical. In fact, talking openly with your patients doubles the odds of them taking their medications properly. Try to understand the reason behind your patients’ non-adherence and address them honestly to build trust.
The SIMPLE Method
You can also use the SIMPLE method to improve medication adherence among your patients.
Simplify the Regimen
It is easy for patients to forget their medication schedule, so you should work with the patient to simplify their medication regimen. Encourage your patients to use adherence tools, like day-of-the-week pill boxes or mobile apps that remind them to take their medicine.
You can also instruct your patients to incorporate taking their medicines into their daily routine. For example, you can schedule taking the medication during mealtime or at bedtime, so that the patient can associate the pill-taking during set activities during the day.
Write down prescription instructions clearly and reinforce them verbally. Go over the prescriptions with the patient, so that they can remember your instructions while they go through what you’ve noted in the prescription. You can also provide websites for additional reading.
Modify Patients’ Beliefs and Behavior
Provide positive reinforcement when patients take their medication successfully. If possible, you can initiate a rewards program and provide incentives, such as subsidized fees charged to providers, to improve medication adherence. You should also talk to patients to understand their concerns and hesitations in taking medications so that you can begin to address their fears.
Provide Communication and Trust
Allow patients to speak freely. Of course, if you’re dealing with many patients in a day, time is of the essence. However, studies show that if patients are given the opportunity, they will talk no longer than 2 minutes to share their concerns. Ask for patients’ input when discussing recommendations and making decisions about their medication regimen.
Use plain language when speaking with patients. Instead of using the word “adherence,” ask your patients “Did you take all of your pills?” You can also remind your patients to contact your office if they have any other questions about their medicine.
Leave the Bias
Understand the predictors of non-adherence and address them as needed with patients. Common predictors of non-adherence are low literacy levels, limited proficiency in the English language, history of mental health issues, belief that medications are unnecessary or harmful, and concerns about side effects and medication costs.
Ask your patients specific questions about their attitudes, beliefs, and cultural norms related to taking medications.
Ask patients simply and directly whether they are sticking to their drug regimen. You can also use a medication adherence scale, such as:
- Morisky-4 (MMAS-4 or Medication Adherence Questionnaire)
- Morisky-8 (MMAS-8)
- Medication Possession Ration (MPR)
- Proportion of Days Covered (PDC)
Ultimately, approaches to overcoming medication adherence barriers must be patient-centered. Most medication challenges are unique to the individual patient preferences. As such, providers need to use unique strategies to help patients.
Health care professionals should start by identifying the patient’s challenge, and then work to overcome it. This will ideally result in better medication adherence and stronger overall patient wellness.