Medication adherence: Pharmacist perspective

Objective: To provide pharmacists with a current, comprehensive review of medication adherence challenges and solutions. Data sources: A computerized search of the PubMed and Medline databases (through July 2008) identified English language review articles on medication adherence using the MeSH terms patient compliance or adherence and medication, drug regimen, or treatment. Study selection: By the authors. Data extraction: The results were filtered to include those published in pharmacy journals, and 117 publications were selected based on the content of their abstracts. The final version of this review article used 55 of the 117 publications. An additional 15 publications that provided examples of specific adherence issues were included. A vignette from the authors' experience was used as a case study. Data synthesis: This article introduces the challenge of patient medication adherence, discusses the various methods by which to monitor medication adherence, describes various treatment- and condition-related barriers to adherence, and discusses the effectiveness of numerous adherence intervention strategies. Conclusion: Nonadherence to a medication regimen may have multiple underlying causes, some of which may be easier to address than others. Open discussion between the pharmacist and patient regarding barriers to adequate medication adherence, followed by a multifaceted, personalized intervention to address these barriers, plays a key role in encouraging patients to adhere to the recommendations of the health care team.