Treatment Adherence: Pharmacist's Keys to Treatment Success

Treatment adherence is one of the fundamental pillars for the success of any pharmacological treatment. However, non-adherence is a global problem affecting millions of patients and has serious consequences for their health. As pharmacists, we have a crucial role in improving this aspect.

What is Treatment Adherence and why is it so important?

Treatment adherence is defined as the extent to which a person's behaviour (taking medication, following a diet, making lifestyle changes) corresponds with recommendations agreed with a healthcare professional. It's not just about taking the medicine, but doing so at the correct dose, at the right time, and for the prescribed duration. It is a broader concept than simple 'compliance', as it implies active and conscious patient participation.

Its importance lies in the fact that low adherence can lead to treatment ineffectiveness, disease progression, development of resistance (especially to antibiotics), increased hospitalisations, and ultimately, a worsening of the patient's quality of life. From the pharmacy, we can identify barriers and offer personalised solutions for each case.

Factors influencing non-adherence and how to identify them

Therapeutic non-adherence is multifactorial and can be due to various reasons. Understanding these factors is the first step to being able to intervene effectively. We can classify them into:

In the pharmacy, through quality pharmaceutical care and active listening, we can detect warning signs and delve into the underlying causes of potential non-adherence. Asking open-ended questions without judgment is key.

Pharmacist strategies to improve adherence

Our position as accessible and approachable healthcare professionals allows us to implement various strategies to promote adherence. These include:

• Patient education and empowerment: Clearly explain the illness, the purpose of the medication, how and when to take it, and what to expect from it (benefits and possible adverse effects). Use simple language and verify patient understanding.
• Personalised Dosage Systems (PDS): For polymedicated patients or those with cognitive difficulties, PDS are an excellent tool. They organise medication by days and doses, simplifying the regimen and reducing errors. You can learn more about the importance of PDS in the pharmacy.
• Reminders and alarms: Suggest the use of mobile alarms, calendars, or pill organisers with reminders.
• Medication review: Conduct periodic reviews to identify duplications, interactions, or complex regimens that can be simplified. This is especially relevant in polymedicated patients.
• Communication with the doctor: In cases of persistent non-adherence or doubts about the treatment, it is essential to communicate with the prescribing doctor to seek joint solutions.
• Support and follow-up: Offer continuous follow-up, demonstrating availability to answer questions and provide emotional support.

Tools and resources for the pharmacist

We have various tools and resources that support us in this work. The summary of product characteristics from the Spanish medicines agency AEMPS (available on CIMA) are an invaluable source of information on each medicine, including administration guidelines and potential adverse effects. Clinical practice guidelines from societies such as SEFAC or SemFyC also offer evidence-based recommendations for the management of various conditions and the improvement of adherence.

Furthermore, pharmacovigilance plays a crucial role. By reporting suspected adverse drug reactions, we contribute to a better understanding of medicines, which in turn can improve patient confidence and, consequently, their adherence. The AEMPS is the reference body in Spain for pharmacovigilance (please check your own national regulator for regulatory matters).

Frequently Asked Questions about Therapeutic Adherence