This is not the first nor will it be the last Tip to address nonadherence to medications in some form or another. After all, adherence with medications is probably among the more important factors related to therapeutic effectiveness (so long as the medication is needed: see last week’s Tip on deprescribing) and is among the most important responsibilities of pharmacists; that is, to help ensure that patients understand and are adherent to their medication regimen. Adherence could be a sticky issue for uninsured patients, who might have difficulty acquiring the medications they need and might purposefully forgo needed treatment.

Fernandez-Lazaro et al examined medication adherence and barriers among low-income, uninsured patients, particularly those with multiple chronic conditions.¹ Nonadherence was reported by 52% of patients in the study. A statistically greater likelihood of adherence was observed in patients who did not receive information about their medications, did not regularly visit a primary health care provider, and who had changes in their treatment plan. Alternatively, nonadherence was statistically lower for patients who reported using pill boxes, having help from an informal caregiver, and who integrated medication dosing into their daily routines.

Adherence to medications is of primary concern to all pharmacists. Pharmacy managers can heed the results of this study and others to take action, among them is to create awareness of patient nonadherence among all staff. Beyond that, managers can promote an environment where even potential nonadherence is addressed through the advocacy of staff by eliciting the support of other primary care providers and informal caregivers, promoting continuity in the patient’s medication regimen, ensuring that every patient is provided at least some written information and preferably oral counseling to the extent it is not rejected, and very importantly to provide patients with tools such as pillboxes, if need be free of charge, as the pharmacy will recoup that small financial loss many times over from loyal patients who are adherent with their medications.

Additional information about Customer Service and Creating and Managing Value can be found in Pharmacy Management: Essentials for All Practice Settings, 4e. If you or your institution subscribes to AccessPharmacy, use or create your MyAccess Profile to sign-in to Pharmacy Management: Essentials for All Practice Settings, 4e. If your institution does not provide access, ask your medical librarian about subscribing.

¹Fernandez-Lazaro CI, Adams DP, Fernandez-Lazaro D, et al. Medication adherence and barriers among low-income, uninsured patients with multiple chronic conditions. Res Social Adm Pharm. 2019;15(6):744-753.