Are you aware that not observing patient safety and medication adherence has consequences? Most patients do not take their medications as prescribed by their health care provider. Medication nonadherence is a growing concern to clinicians, healthcare systems, and other stakeholders because of mounting evidence that it is prevalent and associated with adverse outcomes and higher costs of care. Patient participation is increasingly recognized as a key component in the redesigning of healthcare processes and is advocated as a means to improve patient safety.
This article focuses on the importance of safety and medication adherence, highlighting reasons why people do not adhere to their medication, the consequences of this, and what can be done to improve patient safety and adherence to medication.
According to the World Health Organization (WHO) “Medication adherence is the degree to which the person’s behavior corresponds with the agreed recommendations from a health care provider”.
Adherence means that the patient and doctor work together to improve the patient's health, combining the doctor's advice with the patient's lifestyle, values, and care preferences.
The patients must follow their medication regimen exactly as prescribed by doctors. Skipping doses or stopping the therapy before the end date may result in inadequate treatment of the disorder or condition.
According to the World Health Organization , Patient Safety is “a serious global public health issue” and is defined as “the absence of preventable harm to a patient and reduction of risk of unnecessary harm associated with health care.
Studies estimate that 1 in 10 hospitalized patients in developed countries are harmed by medical errors. Around 1 in every 10 patients is harmed in health care and more than 3 million deaths occur annually due to unsafe care. In low-to-middle-income countries, as many as 4 in 100 people die from unsafe care. Investing in measures which reduce patient harm can yield substantial financial savings and more importantly enhance patient outcomes.
Medication adherence is important as it allows the patient and their healthcare provider to conduct an accurate assessment of how well a drug and dosage work for the specific treatment. Too much or too little of a drug in the system can cause side effects or inefficiency. Improving medication adherence has a greater influence on the health of our population. Medication nonadherence leads to poor outcomes, increasing healthcare service utilization and overall health costs. Nonadherence to cardiovascular medications has been associated with increased risks of morbidity and mortality.
Reasons why people do not adhere to their medications:
Lack of involvement in the treatment decision-making process.
Ignorance by the patients to adhere to the medication.
One feels embarrassed and ashamed. There is still a lot of stigma around mental illness. A study was made about this and discovered that patients who experienced shame over a diagnosis of bipolar disorder had the highest rates of nonadherence to their medications. Some people think that taking medicines for depression or other mental illnesses is a sign of weakness. Lack of involvement in the treatment decision-making process.
Ignorance by the patients to adhere to the medication.
One feels embarrassed and ashamed. There is still a lot of stigma around mental illness. A study was made about this and discovered that patients who experienced shame over a diagnosis of bipolar disorder had the highest rates of nonadherence to their medications. Some people think that taking medicines for depression or other mental illnesses is a sign of weakness.
Prescription of complex drug regimens. One does not understand the medication instructions because the language used is confusing. Also, it is advisable to prescribe medications with less frequent dosing or combination pills to reduce complexity.
Ineffective communication of information about adverse effects of the medication.
High costs of medication which makes it difficult for patients to afford their prescriptions consistently.
One wants instant results. People often stop their medications because they do not feel better right away.
Lack of health information technology.
When the side effects are worse than the condition. Some medication has mild side effects such as headaches, but some drugs such as antidepressants and chemotherapy drugs could make one gain weight, lose hair, and experience sexual or fertility problems. These are potential reasons why someone might think that stopping taking the medication would seem like the right move.
Among healthcare workers, the acceptance and promotion of patient participation are influenced by; the desire to maintain control, lack of time, personal beliefs, types of illness, and training in patient-caregiver relationships.
Lack of symptoms. People stop taking their medication when they do not feel symptomatic and may believe that continuing to take medication is unnecessary.
Difficult in accessing pharmacies or healthcare providers can hinder medication adherence.
Fear of dependency. Concern about dependence on medication.
Prescription of complex drug regimens. One does not understand the medication instructions because the language used is confusing. Also, it is advisable to prescribe medications with less frequent dosing or combination pills to reduce complexity.
Ineffective communication of information about adverse effects of the medication.
High costs of medication which makes it difficult for patients to afford their prescriptions consistently.
One wants instant results. People often stop their medications because they do not feel better right away.
Lack of health information technology.
When the side effects are worse than the condition. Some medication has mild side effects such as headaches, but some drugs such as antidepressants and chemotherapy drugs could make one gain weight, lose hair, and experience sexual or fertility problems. These are potential reasons why someone might think that stopping taking the medication would seem like the right move.
Among healthcare workers, the acceptance and promotion of patient participation are influenced by; the desire to maintain control, lack of time, personal beliefs, types of illness, and training in patient-caregiver relationships.
Lack of symptoms. People stop taking their medication when they do not feel symptomatic and may believe that continuing to take medication is unnecessary.
Difficult in accessing pharmacies or healthcare providers can hinder medication adherence.
Fear of dependency. Concern about dependence on medication.
Strategies to improve patient safety and medication adherence include:
Educating patients about their conditions and the importance of adhering to their specific medication. Patients should be provided with clear, comprehensive information about the medication, including its purpose, benefits, and potential side effects. Loss of situational awareness can result in serious compromise to patient safety if it is not recognized by either the individual or clinical team.
Forming support groups such as community support groups that can provide the needed encouragement for patients to ask questions and discuss any concerns they have about their medication and provide reminders to patients to adhere to their medication regimens.
Improving providers’ recognition and understanding of patients’ beliefs, fears, and values, as well as their own biases.
Simple language and visual aids should be used to ensure patients understand how to take their medication correctly.
Medication reminders such as alarms, smartphone apps, or automated calls to remind patients to take their medication.
Regular follow-ups. Regular check-ups to monitor adherence to medication and address any issues.
Financial assistance to help the patients afford their medication.
Addressing side effects of the medication and how to manage them.
In conclusion, adherence to medication helps in preventing avoidable complications and adverse drug defects. The pursuit of patient safety and medication adherence is a continuous journey and each day is for us to learn more and create awareness so that people can know that failure to adhere to medication has severe consequences which are costly. By understanding the significance of the importance of patient safety and medication adherence and implementing strategies to improve them can transform patient care, ultimately leading to healthier communities and more resilient healthcare systems. A thorough understanding of the role of human factors in error in health care for improving patient safety is important.
