MEDICATION ADHERENCE

Medication Adherence

Medication Adherence

Medication adherence is one of the most important and challenging issues facing healthcare professionals and patients. Soon after the advent of HIV medications, it became obvious that taking your medicines exactly as prescribed was essential for an effective drug regimen. It also became apparent that factors affecting medication adherence are plentiful. If a person is to adhere to their medication, (Kirsch & Council 2002) the medical provider must first identify factors that affect medication adherence, or the likelihood that that patient will take his medication as prescribed. Assessing adherence before prescribing a regimen will help ensure a patient stays on an effective treatment plan. To better understand what's needed for an effective HIV medication regimen, let's take a look at those factors affecting medication adherence.

Non-adherence is associated with increased risk of relapse and hospitalization (Mayes Calhoun & Crowell 2000), the most expensive health service component in the treatment of schizophrenia. While the link between non-adherence and psychiatric hospitalization is well documented, little is known about the relationships between adherence and utilization of other mental-health resources in the management of schizophrenia, such as emergency services, partial hospitalization, and various outpatient services. The complexities of the illness and the heterogeneity of mental-health outpatient services call for data-driven analyses characterizing the use of specific categories of mental-health resources [8]. Outpatient services, including individual therapy, psychosocial and rehabilitation group therapy, case management, and medication management, may be conceptualized as "expectable" healthcare resources because the management of schizophrenia requires comprehensive and continuous care. Lack of expected outpatient resource utilization may signal that a patient is not engaged in the treatment plan and may therefore be non-adherent with medication and at increased risk of relapse and hospitalization (Parker & Frankenberger 2000).

Recent research also suggests that adherence is not an "all or none" phenomenon as many patients appear to be partially adherent with treatment, failing to take their medications as prescribed and having gaps in medication intake. Therefore, studies now often evaluate categories of adherence, including partial adherence, non-adherence and full adherence. Furthermore, the stability of medication adherence over time has received sparse attention, as has the potential impact of hospitalization on medication adherence level following hospital discharge. Although adherence has often been assumed to be a stable patient characteristic, recent data suggest that adherence level is not fixed (Barabasz Barabasz 2006), with non-adherent patients displaying less stable adherence status compared with adherent patients.

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