scholarly journals Medication Nonadherence: Implications for patient health outcomes in pharmacy practice

2021 ◽  
pp. 416-428
Author(s):  
AHMED ALAA AL-TEMIMI ◽  
Sunanthiny Krishnan ◽  
Anisha Kaur Sandhu ◽  
Nida Sajid Ali Bangash
Keyword(s):  
Medication Adherence ◽  
Health Outcomes ◽  
Patient Adherence ◽  
Healthcare Providers ◽  
Pharmacy Practice ◽  
Primary Objective ◽  
Medication Nonadherence ◽  
Patient Health ◽  
Improve Patient Adherence ◽  
Improved Design

ABSTRACT Objectives: The primary objective of this review is (1) to better understand the prevalence and impact of medication nonadherence, (2) to identify risk factors for medication nonadherence, (3) to understand the association between nonadherence and its implications on patient health outcomes in pharmacy practice, and (4) to study interventions designed to improve patient adherence to prescribed medications for medical conditions, considering its impact on both medication adherence and patient health outcomes.   Methods: Published journal articles were manually sorted. Additional references were obtained from citations within the retrieved articles. This review surveyed the findings of the identified articles with data extracted to presents various strategies and resources on medication nonadherence related to patients and healthcare providers. English languages were considered inclusion criteria in reviewing published articles related to medication nonadherence. This review also surveyed identified articles to determine both subjective and objective medication adherence measures. Key findings: The research in this field needs advances, including improved design of feasible long‐term interventions, objective adherence measures, and sufficient study power to detect improvements in patient health outcomes.   Conclusion: Current methods of improving medication adherence for chronic health problems are mostly complex and ineffective so full benefits of treatment cannot be realized. To date, monitoring of patient medication adherence and use of interventions to improve adherence are rare in routine clinical practice.

scholarly journals Designing and Adapting Services to Create Value Outside a Hospital Using Blockchain Architecture

2020 ◽  
Vol 2 (1) ◽  
pp. 44-67
Author(s):  
Mohan Rao Tanniru ◽  
Robert Tanniru
Keyword(s):  
Patient Adherence ◽  
Clinical Care ◽  
Healthcare Providers ◽  
Care Facility ◽  
Future Research ◽  
Communication Architecture ◽  
Provider Network ◽  
Treatment Plans ◽  
Improve Patient Adherence ◽  
Electronic Medical Record Systems

As healthcare systems develop innovative services to create value for patients outside the hospital or clinical care facility, they face a major challenge. They need a communication architecture to support the sharing of information among the healthcare providers, patients, and external partners to fulfill the value created. The current electronic medical record systems of hospitals do not extend to many of these external partners unless they are part of the provider network. This paper proposes the use of blockchain architecture to address this challenge. By modeling service innovations used to create value as a set of service exchanges among providers, patients, and partners, the providers decide when blockchain architecture may complement their own extended EMR system in fulfilling the value they create to address patient needs. The authors use gamification to improve patient adherence to treatment plans designed to fulfill the value created and adapt the value created to reflect the changing patient ecosystem. The paper concludes with discussion and directions for future research.

Gamification to Improve Adherence to Clinical Treatment Advice

2017 ◽  
pp. 80-111 ◽  
Author(s):  
Deborah Richards ◽  
Patrina H.Y. Caldwell
Keyword(s):  
Health Outcomes ◽  
Patient Adherence ◽  
Token Economy ◽  
Medical Advice ◽  
Virtual Character ◽  
Scarce Resources ◽  
Game Mechanics ◽  
Improve Patient Adherence ◽  
Improve Patient

This chapter looks at how gamification of existing technology can be used to incorporate the factors that have been found to improve patient adherence. Lack of adherence to medical advice is a major problem because it reduces the likelihood of improved health outcomes and is a waste of costly and scarce resources. To provide intrinsically motivating game mechanics we discuss the use of an embodied virtual character to build an ongoing therapeutic alliance with the patient. Extrinsically motivating game mechanics are added via a game based on the token economy. The intention is to empower, engage and encourage the patient to adhere with the medical advice. A case study is provided for the condition of paediatric incontinence.

scholarly journals Does the Polypill Improve Patient Adherence Compared to Its Individual Formulations? A Systematic Review

Pharmaceutics ◽  
2020 ◽  
Vol 12 (2) ◽  
pp. 190
Author(s):  
Ana Baumgartner ◽  
Katarina Drame ◽  
Stijn Geutjens ◽  
Marja Airaksinen
Keyword(s):  
Systematic Review ◽  
Medication Adherence ◽  
Patient Adherence ◽  
Chronic Illnesses ◽  
Cochrane Library ◽  
Small Range ◽  
Therapy Regimen ◽  
Improve Patient Adherence ◽  
Meta Analyses ◽  
Multiple Drugs

Many patients, especially those with a high pill burden and multiple chronic illnesses, are less adherent to medication. In medication treatments utilizing polypills, this problem might be diminished since multiple drugs are fused into one formulation and, therefore, the therapy regimen is simplified. This systematic review summarized evidence to assess the effect of polypills on medication adherence. The following databases were searched for articles published between 1 January 2000, and 14 May 2019: PubMed, Web of Science, Cochrane Library, and Scopus. Medication adherence was the only outcome assessed, regardless of the method of measuring it. Sixty-seven original peer-reviewed articles were selected. Adherence to polypill regimens was significantly higher in 56 articles (84%) compared to multiple pill regimens. This finding was also supported by the results of 13 out of 17 selected previously published systematic reviews and meta-analyses dealing with this topic. Adherence can be improved through the formulation of polypills, which is probably why the interest in researching them is growing. There are many polypills on the market, but the adherence studies so far focused mainly on a small range of medical conditions.

scholarly journals Can Technology Improve Adherence to Long-Term Therapies?

2009 ◽  
Vol 3 (3) ◽  
pp. 492-499 ◽  
Author(s):  
Gérard Reach
Keyword(s):  
Cost Saving ◽  
Health Outcomes ◽  
Medical Treatment ◽  
Diabetes Care ◽  
Patient Adherence ◽  
Fear Of Hypoglycemia ◽  
Improve Patient Adherence ◽  
Contemporary Medicine ◽  
Improve Patient

Background: Therapeutic nonadherence is defined as the lack of equivalence between the behavior of the patients and their prescribed medical treatment. Consequences of nonadherence include not only health outcomes, but also cost saving. Thus, this issue gets paramount importance in contemporary medicine. Method: The aim of this article is to discuss the relationships between technology and adherence by asking the following three questions. (1) How can technology be used to monitor patient adherence? (2) Considering the mechanisms of nonadherence in chronic diseases, is there room for technology in interventions aimed to improve patient adherence? (3) What about adherence to technology in diabetes care? Results and Conclusion: Technology may help improve adherence to long-term therapies by (1) giving a concrete representation of adherence rewards, (2) overcoming immediate obstacles to adherence, such as the fear of hypoglycemia, and (3) providing an opportunity for patient-doctor conversations. This assumes, however, that both the patient and the doctor are convinced that technologies are useful.

Gamification to Improve Adherence to Clinical Treatment Advice

2016 ◽  
pp. 47-77 ◽  
Author(s):  
Deborah Richards ◽  
Patrina H.Y. Caldwell
Keyword(s):  
Health Outcomes ◽  
Patient Adherence ◽  
Token Economy ◽  
Medical Advice ◽  
Virtual Character ◽  
Scarce Resources ◽  
Game Mechanics ◽  
Improve Patient Adherence ◽  
Improve Patient

This chapter looks at how gamification of existing technology can be used to incorporate the factors that have been found to improve patient adherence. Lack of adherence to medical advice is a major problem because it reduces the likelihood of improved health outcomes and is a waste of costly and scarce resources. To provide intrinsically motivating game mechanics we discuss the use of an embodied virtual character to build an ongoing therapeutic alliance with the patient. Extrinsically motivating game mechanics are added via a game based on the token economy. The intention is to empower, engage and encourage the patient to adhere with the medical advice. A case study is provided for the condition of paediatric incontinence.

Creating and testing regulatory focus messages to enhance medication adherence

2018 ◽  
Vol 15 (2) ◽  
pp. 124-137
Author(s):  
Ashley O’Connor ◽  
Amy Ladebue ◽  
Jamie Peterson ◽  
Ryan Davis ◽  
Susan Jung Grant ◽  
...  
Keyword(s):  
Medication Adherence ◽  
Regulatory Focus ◽  
Patient Adherence ◽  
Regulatory Fit ◽  
Structured Interviews ◽  
Motivational Messages ◽  
Prevention Messages ◽  
Improve Patient Adherence ◽  
And Control ◽  
The Impact

Objectives Strategies were explored to improve patient adherence to cardioprotective medications by borrowing from a motivational framework used in psychology, regulatory focus theory. The current study is part of a larger randomized control trial and was aimed at understanding what written educational messages, based on patients’ regulatory focus tendency, resonated with each individual as a potential reminder to take medications. This study was also aimed at understanding why messages resonated with the patients. Methods Twenty veterans were tested for regulatory fitand presented with messages dependent on focus tendency. In-person semi-structured interviews were conducted to collect feedback of messages. An iterative analysis drawing primarily on matrix and reflexive team analyses was conducted. Result Six promotion and six prevention messages emerged, such as “team up with your provider to create a combination of medications to prevent illness” and “Live your best life – Take your medications”. Five themes related to types of health messages that spoke to patients’ regulatory fit were discovered: relatability; empowerment and control; philosophy on life; relationship with provider and medications; and vocabulary effect on the impact of messages. Discussion Motivational messages based on regulatory fit may be useful in improving patient medication adherence, leading to improved cardiovascular outcomes.

Oncology boot camp: A preparatory curriculum for advanced pharmacy practice experience students

2021 ◽  
pp. 107815522110191
Author(s):  
Bethannee Horn ◽  
Lyn Wells ◽  
Zachery Halford
Keyword(s):  
Student Perceptions ◽  
Pharmacy Practice ◽  
Boot Camp ◽  
Primary Objective ◽  
Comfort Level ◽  
Post Intervention ◽  
Student Knowledge ◽  
Survey Tool ◽  
Practice Experience ◽  
Drug Knowledge

Introduction The primary objective of this study was to evaluate the effectiveness of an autonomous oncology boot camp on Advanced Pharmacy Practice Experience (APPE) student knowledge. Secondary objectives included assessing student perception of the virtual learning experience and overall comfort level with the material. Methods APPE students rotating through our institution between November 2019 and March 2020 were voluntarily enrolled in a 4-hour oncology-focused boot camp, which included five PlayPosit (Denver, CO, USA) interactive video lectures embedded with case-based application questions followed by one comprehensive web-based Quandary (Victoria, BC, Canada) action-maze case. Student learning was measured by a pre- and post-intervention exam. A web survey tool (Qualtrics, Provo, UT, USA) collected student perceptions evaluating their comfort with oncology-specific drug knowledge and APPE rotations tasks. Results Fifty students enrolled in the oncology boot camp, with 100% completing the pre- and post-intervention assessments. Overall, pre-intervention exam scores (mean: 55.4%, SD: 21.8%) improved by 23.2% following the boot camp (mean: 78.6%, SD: 19.2%; p < 0.001). Students performed better on all 10 exam questions, with 6 questions showing a statistically significant improvement (p < 0.05). Forty-five students (90%) completed the perception surveys. Of those, 93% agreed that it effectively reinforced important oncology knowledge, 91% supported the autonomous design, and 82% would recommend the oncology boot camp for future students. Conclusion The boot camp proved to be a beneficial educational tool that enhanced student knowledge and confidence in navigating common oncology concepts. Students valued the ability to independently complete the activities and supported its continuation.

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