Medication Adherence

What is Medication Adherence?

Medication adherence is generally defined as the extent to which patients take their medications as prescribed by their healthcare providers. This includes getting prescriptions filled, remembering to take medications on time, and understanding the directions. While this may sound simple, medication adherence is one of the biggest challenges faced by healthcare professionals today. It’s also cause for concern for patients and caregivers alike: 30 percent of Canadians are concerned about their own medication adherence or of someone they love.

Why is Medication Adherence Important?

Simply put, “drugs don’t work in patients who don’t take them.”[i] And unfortunately, many patients don’t take the medications they need to properly treat their conditions. According to a World Health Organization report, “Adherence to long-term therapy for chronic illnesses in developed countries averages 50%.”[ii]

Poor adherence to medical treatment compromises health outcomes, especially in patients with chronic diseases, such as coronary artery disease, hypertension, osteoporosis, asthma, diabetes, dementia and others. For example, low adherence has been identified as the primary cause of unsatisfactory control of blood pressure.[iii]

Barriers to Medication Adherence

There are many reasons why patients can’t, or don’t, take their medications correctly. Factors that affect adherence include the high cost of medications, difficulty following complex dosing schedules, confusion about how and when to take medications, and a lack of knowledge about an illness and the effects of treatment.

Affordability:  Here in Canada, while we receive universal coverage for medically necessary hospital and physician services, pharmaceutical coverage is incomplete. As a result, about one in 10 Canadians can’t follow a course of treatment because they are unable to afford their prescription medication. [iv]

Complicated Dosing Schedules:  Adherence to treatment is vital to the well being of elderly patients, many who have multiple chronic diseases and must take multiple medications. This leads to complex dosing schedules, which, when combined with mental and physical impairments prevalent in elderly patients, presents a barrier to medication adherence.

Understanding your own health conditions: Inadequate health literacy contributes to a lack of understanding of a disease and medication instructions, which in turn, contributes to non-adherence. Figures show that 60% of adults and 88% of seniors in Canada are not health literate.[v]

Improving Medication Adherence

For patients to fully benefit from treatment, they have to adhere to prescribed medication regimens. And while improving adherence is not the sole responsibility of the patient, there are some things you can do to help.

Get to know your pharmacist and the staff. And let them get to know you, your family, and your medical history.

Talk with the pharmacist and ask questions, especially when you’re prescribed a new medication. If side effects are bothering you, they may be able to switch you to a different medication or adjust the dose. If paying for prescription drugs is a problem, they may be able to prescribe a less expensive alternative medication.

Staying organized is also effective in promoting better adherence. Keep your medications where you’ll notice them, and if you take multiple medications, ask your pharmacist about adherence packaging, like MedPack. Having your medications pre-sorted minimizes the risk of missing a dose, or taking the wrong pill at the wrong time.

While medical advancements are being made all the time, the World Health Organization found that “Increasing adherence may have a greater effect on health than any improvement in specific medical treatments.”[vi]

[i] Former US Surgeon General C. Everett Coop

[ii] Marie T. Brown, MD and Jennifer K. Bussell, MD. Medication Adherence: WHO Cares?;Mayo Clin Proc. 2011 Apr; 86(4): 304–314.

[iii] Sabaté E, editor. , ed. Adherence to Long-Term Therapies: Evidence for Action. Geneva, Switzerland: World Health Organization; 2003.

[iv] Michael R. Law, PhD⇓, Lucy Cheng, MSc, Irfan A. Dhalla, MD MSc, Deborah Heard, BASc, Steven G. Morgan, PhD. The effect of cost on adherence to prescription medications in Canada. CMAJ February 21, 2012 vol. 184 no. 3.

[v] Health Literacy. Public Health Agency of Canada. 2014.

[vi] Sabaté E, editor. , ed. Adherence to Long-Term Therapies: Evidence for Action. Geneva, Switzerland: World Health Organization; 2003.