PATIENT COMPLIANCE - PharmXpert Academy

Watch Pagesosteoporosis researchers concluded, “In this randomisedcontrolled trial, we did not find a statistically significantimprovement in adherence to an osteoporosis medicationregimen using a telephonic motivational interviewingintervention.”Unfortunately, the results of studies like these may resultin programmes like these never starting. As Dr Jon Ebbert(Professor of Medicine at Mayo Clinic) emailed us:Tragically, this may mean that stakeholders may notpay attention to what may be a very promising andinnovative strategy to improve medication adherence.Behavioural strategies have been used very successfullyin getting patients to quit smoking and can be agreat tool in getting patients to take their physicianprescribedmedication.So, the next time you start to think about an adherenceprogramme, take a page from smoking cessation – make sureit listens to patients and responds to their individual needs inimproving medication adherence.This patient-centric approach should be a part of each andevery strategic decision.Why? Because the old marketing adage that the customeris always right applies even to the healthcare industry. Don’tdiscount such things as complaints of side-effects, lifestyleinconveniences, and forgetfulness -- listening and respondingmay be the difference between an adherent patient and anon-adherent patient.gave individualised and group counselling and advice.More importantly, we applied techniques that we knewwould work. We were not encumbered with the need anddesire to wait for clinical trial data, or have confirmed anddocumented returns on investments from other smokingcessation programmes before starting the Little Saigonprogramme.Waiting for this data before acting is truly regrettable.Recently, for example, the Archives of Internal Medicinereported on the results of a study to examine whether atelephone-based counselling programme rooted inmotivational interviewing would improve adherence toosteoporosis medication.For this study, more than 1000 Medicare patients who hadbeen newly prescribed osteoporosis medication were dividedinto a control group, who were mailed educational materials,and an intervention group, who received telephone-basedcounselling.Median medication adherence was 49% in the telephonegroup and 41% in the control group. In short, as theReferences1. Jennifer Stuber et al., “Smoking and the emergenceof a stigmatized social status” Social Science andMedicine (May 2008) http://deepblue.lib.umich.edu/bitstream/2027.42/60953/1/stuber_smoking%20and%20stigma_2008.pdf (accessed April 8, 2012).2. A Provider’s Handbook on Culturally Competent Care,Smoking Among Asian Americans: A National TobaccoSurveyMichael Wong is the founder of thePhysician-Patient Alliance for Health &Safety (PPAHS). PPAHS is an advocacygroup devoted to improving patienthealth and safety; and is composedof physicians, patient advocates, andprofessional healthcare organizations,and can be found at www.ppahs.org Like a serial entrepreneur,Mike has been behind many healthcare initiatives, includingencouraging people to quit smoking, get tested and treatedfor hepatitis, and take their medications as prescribed by theirphysicians. As well, he has helped improve access to healthcare.Email: mwong@ppahs.orgwww.JforPC.comJournal For Patient Compliance Strategies to enhance Adherence and Health Outcomes 13