Strategies for Improving Strategies for Improving Medication AdherenceMedication Adherence

Assess Patient Understanding and Assess Patient Understanding and BehaviorBehavior

What we need to know and understand is:What we need to know and understand is: How do patients feel about having to take the How do patients feel about having to take the

medication?medication? What do they think will happen to their health What do they think will happen to their health

if they don’t take the medication as if they don’t take the medication as prescribed?prescribed?

Assessing Understanding of Assessing Understanding of Medication Purpose: Use of Open-Medication Purpose: Use of Open-

Ended QuestionsEnded Questions What did your doctor tell you about this What did your doctor tell you about this

medicine?medicine? What exactly is your medicine supposed to What exactly is your medicine supposed to

do?do? What problem has caused you to need this What problem has caused you to need this

medicine?medicine?

Assessing Future BehaviorAssessing Future Behavior

Using open-ended questions we can learn Using open-ended questions we can learn about our patient’s medication taking about our patient’s medication taking behaviors:behaviors: When do you plan to take your medication?When do you plan to take your medication? How long are you going to be taking your How long are you going to be taking your

medication?medication? What did your doctor tell you to do if you What did your doctor tell you to do if you

missed a dose?missed a dose? How should you be storing this medication?How should you be storing this medication?

Assessing Past BehaviorAssessing Past Behavior

This kind of probing can also help us This kind of probing can also help us understand past behavior:understand past behavior: How have you been taking this medication?How have you been taking this medication? How has taking this medication changed your How has taking this medication changed your

daily schedule, habits, etc.?daily schedule, habits, etc.? How many doses of this medication have you How many doses of this medication have you

missed in the last week?missed in the last week? What caused you to miss these doses?What caused you to miss these doses?

Assessing Medication Assessing Medication EffectivenessEffectiveness

How do you know if your cholesterol / blood How do you know if your cholesterol / blood pressure medication is working?pressure medication is working?

How often do you get your blood pressure How often do you get your blood pressure checked?checked?

What was your last TC reading?What was your last TC reading?

Assessing Potential Medication Assessing Potential Medication ProblemsProblems

What kinds of problems are you having?What kinds of problems are you having? What side effects have you noted since you What side effects have you noted since you

started taking this medication?started taking this medication? What side effects are you supposed to look What side effects are you supposed to look

for?for?

False Assumptions about Patient False Assumptions about Patient Understanding and Medication Understanding and Medication

AdherenceAdherence Don’t assume that: Don’t assume that:

doctors have talked to their patients.doctors have talked to their patients. patients understand all the information you give them.patients understand all the information you give them. if the patient understands, they will just take the medication as if the patient understands, they will just take the medication as

required.required. because someone does not take the medication as directed that because someone does not take the medication as directed that

they don’t care or aren’t motivated.they don’t care or aren’t motivated. just because someone takes their medication correctly now, they just because someone takes their medication correctly now, they

will continue to do so.will continue to do so. doctors monitor patient compliance.doctors monitor patient compliance. patients who are having problems will ask you for help.patients who are having problems will ask you for help.

Techniques to improve patient Techniques to improve patient understandingunderstanding

Examine your own attitude toward patient counseling.Examine your own attitude toward patient counseling. Emphasize key points.Emphasize key points. Give reasons why something is important (antibiotics).Give reasons why something is important (antibiotics). Give concrete instructions.Give concrete instructions. Present key information at the beginning and the end Present key information at the beginning and the end

of your discussions.of your discussions. Use written information to back up your verbal Use written information to back up your verbal

counseling.counseling. Verify what patients have learned.Verify what patients have learned.

Techniques to Improve Patient Techniques to Improve Patient BehaviorBehavior

Teach them to integrate new behaviors with current behaviors.Teach them to integrate new behaviors with current behaviors. Provide good aids when you can, like pill organizers, counter Provide good aids when you can, like pill organizers, counter

caps, alarms etc.caps, alarms etc. Help patients with self monitoring options, log books, calendars, Help patients with self monitoring options, log books, calendars,

etc.etc. Monitor medication use on your end –refill records – and Monitor medication use on your end –refill records – and

encourage patients where appropriate.encourage patients where appropriate. Refer patients with extreme or special needs to appropriate help Refer patients with extreme or special needs to appropriate help

– Medicaid, various medication assistance programs, reading – Medicaid, various medication assistance programs, reading comprehension services, and so on.comprehension services, and so on.