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Adherence to medication plays a crucial role in maintaining and improving clinical outcomes. Medication adherence is usually reduced among patients suffering from multiple chronic conditions. For instance, in the case study, the patient is an elderly woman suffering from multiple coexisting conditions such as osteoarthritis, hypertension, non-insulin-dependent diabetes mellitus, hypothyroidism, and coronary heart disease.
The patient is not adhering to her medication regimen. This is because she expressed some concerns to the nurse about her medication that proves so. For instance, she is experiencing difficulties in purchasing, managing, and scheduling the intake of the medication. Moreover, she discloses that she does not always take the medications as prescribed. Finally, the elderly lady is taking a large number of drugs including herbal medications. Thus, judging from her age and the fact that she stays alone, it might be difficult for her to adhere to medication.
Reasons for Non-adherence
The two potential primary reasons for non-adherence comprise polypharmacy and poor management and scheduling of medication.
Interventions to improve adherence
The nurse could advocate for medication regimen management, i.e., management of polypharmacy. A combination of pills for multiple chronic conditions will be used to reduce the number of pills that the patient takes (Smith et al., 2016).
On the other hand, scheduling and management of medication can be improved through the integration of clinical pharmacist consultation for the co-management of chronic disease (Wallace et al., 2014). This consists of education regarding dosage and the frequency of dosage, disease monitoring either through the telephone or in-person follow-up visits, and refill reminders. All the before-mentioned interventions primarily aim to reduce the daily pill burden.
- Williams, J., Walker, R., Smalls, B., Campbell, J., Egede, L. (2014). Effective interventions to improve medication adherence in Type 2 diabetes: a systematic review. Diabetes Management, 4(1), 29-48.
- Smith, S. M., Wallace, E., O’Dowd, T. &Fortin, M. (2016). Improving outcomes for people with multiple chronic conditions. Cochrane Database of Systematic Reviews, 3 ( CD006560).