New approaches to clinical adherence  

Updated 13th Jul 2020

Clinical adherence is one of the biggest challenges faced by the pharmaceutical business. The World Health Organisation states that improvement would have a bigger impact on health than specific medical advances. It’s the weak link between supply, the pharmacist-patient relationship, and most importantly, patient health. Added to this, we recently reported medicine wastage estimates at £300 million per year; clinical adherence should be everyone’s priority.

What is clinical adherence?

Clinical adherence, put simply, is the extent to which a patient follows their prescribed course of medical care. Most commonly this refers to medicines themselves but can mean the use of medical equipment, self-care, and therapy sessions.

Factors affecting adherence

Multiple factors affect a patient’s ability or desire to take their medicines – it’s not always down to a lack of interest. Let’s look at some of the barriers to adherence, both self-imposed and otherwise.A group of factors primarily affects vulnerable parts of society. Age –children and the elderly – can explain a lack of interest in, understanding and awareness of, sticking to a schedule of taking medicines. Literacy, and so-called ‘health literacy’, specifically about understanding treatment directions, also affects disadvantaged groups.Related to age and those less able is the major factor of physical ability. Even pillboxes, not just complicated equipment, can prove troublesome for some patients. Conversely, aerosols are shown to have a positive impact on adherence due to their convenience and ease of use.While they affect fewer patients, there are issues not to be forgotten. Cultural and religious beliefs can lead to differing attitudes and mistrust of healthcare providers, as well as leave some individuals outside mainstream systems. Furthermore, whilst the cost of medicines doesn’t affect UK patients in the same way as the US, for example, paying for prescriptions or applying for a concession is effectively another barrier.

What can pharmacists do?

The responsibility doesn’t lie solely with either the patient or the pharmacist. However, there are undoubtedly ways in which we can make it easier, especially given some of the involuntary factors involved.Digital tracking, telephone interventions, and one-to-one education have all recently proven to increase adherence by strengthening the patient-pharmacist relationship.

Tools available to patients

On the patient side, apps like ours address many of the common problems with adherence. By grouping pharmacy services such as re-ordering prescriptions, booking appointments, and reminders, everything related to a patient’s medicine is in one place. There’s even a secure chat function through the ability to nominate their chosen pharmacy and GP.While clinical adherence remains a challenge, the hope is to remove the burden. To have, as one user described the app, “all bases covered” in making the process as easy as possible.

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