In chronic disease management, adherence to prescribed medications plays a pivotal role in managing and mitigating various health conditions. Medication nonadherence can lead to inadequate disease control, exacerbation of symptoms and an increased risk of complications, ultimately diminishing the patient’s quality of life1; however, 50-60% of patients with chronic illnesses miss doses, take the wrong doses, or drop off treatment in the first year2.
Certain medications play a crucial role in preserving cognitive function, especially in conditions like Alzheimer’s disease. Medication nonadherence can accelerate cognitive decline, negatively impacting an individual’s ability to perform daily tasks and maintain independence3. The uncertainty of living with poorly managed health has been shown to contribute to heightened stress and anxiety levels4; it can also create a financial strain, due to an increase in avoidable hospitalizations (estimations show that up to 70% of medication-related hospital admissions are linked to medication nonadherence2).
Chronic conditions aggravated by medication nonadherence can impede individuals from fully participating in work and social activities5 and the reduced ability to engage in daily tasks and contribute to society can have profound effects on self-esteem and overall life satisfaction6. A previous study has shown that patients with asthma resulted in productivity losses of up to ± $1,024 per patient per year7. This potential loss of income due to missed work, coupled with the astounding financial burden associated with medical nonadherence (research has estimated that costs associated with chronic mental health conditions were as high as $19,000 in 20158), can create a significant strain on individuals and families9.
Medication nonadherence doesn’t just affect the individual, it strains relationships with family, friends, and caregivers. The stress of caring for someone dealing with the repercussions of nonadherence can lead to uneasy connections and emotional exhaustion10. Studies have shown that family caregiver burden has a direct negative effect on medication adherence11; however, it has also been shown that support from family and friends has a positive impact on medication adherence12. Therefore, it is crucial to develop strategies that help caregivers, family, and friends cope with their loved one’s illness.
Consistently following prescribed medication regimens empowers individuals to better manage their health conditions, preventing the exacerbation of symptoms and reducing the risk of complications by gaining the full efficacy of their medication1. When patients unintentionally miss doses, there is an effective solution to help increase compliance – the successful formation of new habits. Research shows that the first 66 days are crucial in habit formation13. This has been shown to have a strong positive correlation with medication adherence, possibly because taking medication is a repetitive, daily behavior that is associated with contextual clues14, 15. Suggesting the importance of focusing attention on medication adherence, specifically within these first 66 days. By promoting this practice, healthcare professionals can provide patients with a structured framework that not only promotes adherence to treatment regimens but also contributes to overall well-being, empowerment, and a sense of control over their health.
References
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Bosworth HB, Granger BB, Mendys P, Brindis R, Burkholder R, Czajkowski SM, Daniel JG, Ekman I, Ho M, Johnson M, Kimmel SE, Liu LZ, Musaus J, Shrank WH, Whalley Buono E, Weiss K, Granger CB. Medication adherence: a call for action. Am Heart J. 2011 Sep;162(3):412-24. doi: 10.1016/j.ahj.2011.06.007. PMID: 21884856; PMCID: PMC3947508.
Smith, D., Lovell, J., Weller, C., Kennedy, B., Winbolt, M., Young, C., & Ibrahim, J. (2017). A systematic review of medication non-adherence in persons with dementia or cognitive impairment. PLOS ONE, 12(2). https://doi.org/10.1371/journal.pone.0170651
Nasif, J. (2015). The emotional impact of chronic illness. Journal of Psychology & Clinical Psychiatry, 3(6). https://doi.org/10.15406/jpcpy.2015.03.00177
“Medication Adherence: A Call for Action.” American Heart Journal, vol. 162, no. 3, Sept. 2011, pp. 412–424, www.ncbi.nlm.nih.gov/pmc/articles/PMC3947508/, https://doi.org/10.1016/j.ahj.2011.06.007.
Oluwole, E., Osibogun, O., Adegoke, O., Adejimi, A., Adewole, A., & Osibogun, A. (2019). Medication adherence and patient satisfaction among hypertensive patients attending outpatient clinic in Lagos University Teaching Hospital, Nigeria. Nigerian Postgraduate Medical Journal, 26(2), 129. https://doi.org/10.4103/npmj.npmj_48_19
Joshi, A. V., Madhavan, S. S., Ambegaonkar, A., Smith, M., Scott, V. (Ginger), & Dedhia, H. (2006). Association of medication adherence with workplace productivity and health-related quality of life in patients with asthma. Journal of Asthma, 43(7), 521–526. https://doi.org/10.1080/02770900600857010
Cutler, Rachelle Louise, et al. “Economic Impact of Medication Non-Adherence by Disease Groups: A Systematic Review.” BMJ Open, vol. 8, no. 1, Jan. 2018, p. e016982, bmjopen.bmj.com/content/bmjopen/8/1/e016982.full.pdf, https://doi.org/10.1136/bmjopen-2017-016982. Accessed 16 Oct. 2019.
McGuire, M., & Iuga. (2014). Adherence and Health Care Costs. Risk Management and Healthcare Policy, 35. https://doi.org/10.2147/rmhp.s19801
Kretchy, I. A., Osafo, J., Agyemang, S. A., Appiah, B., & Nonvignon, J. (2018). Psychological burden and caregiver-reported non-adherence to psychotropic medications among patients with schizophrenia. Psychiatry Research, 259, 289–294. https://doi.org/10.1016/j.psychres.2017.10.034
Liu, L., Huang, W., Huang, Z., Liu, J., Zheng, X., Tang, J., Wu, Y., Wang, X., Liao, Y., & Cong, L. (2022). Relationship between family caregiver burden and medication adherence in patients with mechanical valve replacement: A structural equation model. Patient Preference and Adherence, Volume 16, 3371–3382. https://doi.org/10.2147/ppa.s383269
Guo, Aizhen, et al. “Impact of Health Literacy and Social Support on Medication Adherence in Patients with Hypertension: A Cross-Sectional Community-Based Study.” BMC Cardiovascular Disorders, vol. 23, no. 1, 19 Feb. 2023, https://doi.org/10.1186/s12872-023-03117-x. Accessed 3 Mar. 2023.
Lally, Phillippa, et al. “How Are Habits Formed: Modelling Habit Formation in the Real World.” European Journal of Social Psychology, vol. 40, no. 6, 2010, pp. 998–1009, citeseerx.ist.psu.edu/viewdoc/download?doi=10.1.1.695.830&rep=rep1&type=pdf, https://doi.org/10.1002/ejsp.674.
Badawy, Sherif M, et al. “Habit Strength, Medication Adherence, and Habit-Based Mobile Health Interventions across Chronic Medical Conditions: Systematic Review.” Journal of Medical Internet Research, vol. 22, no. 4, 28 Apr. 2020, p. e17883, https://doi.org/10.2196/17883.
Fontanet, Constance P., et al. “Randomised Controlled Trial Targeting Habit Formation to Improve Medication Adherence to Daily Oral Medications in Patients with Gout.” BMJ Open, vol. 11, no. 11, 1 Nov. 2021, p. e055930, bmjopen.bmj.com/content/11/11/e055930, https://doi.org/10.1136/bmjopen-2021-055930. Accessed 11 Mar. 2024.