Time to get personal about adherence

Poor medication use in patients with long-term health conditions is widely recognised as a global problem that urgently needs to be addressed, but there is still debate about the best ways of doing this.

For many years adherence interventions have been based on the misconception that non-adherence primarily occurs because patients forget to take their medicines, and so the associated interventions are essentially reminder-based (see Model Behaviour feature on page 31-33 of the February 2015 issue of PME for more information).

Evidence from a large number of research studies, have shown us that there are many different psycho-social factors that can cause non-adherence. These factors will vary from patient to patient over time, as their experience of the illness and treatment or their social circumstances change.

This is why it's time to 'get personal' in our understanding and management of non-adherence and to ensure that patients receive support strategies and interventions that are personalised based on their own individual adherence barriers.

At the very beginning of any patient support programme, we need to screen each patient carefully to uncover the specific reasons for their non-adherence in order to know what underlying factors or beliefs need to be addressed.

In recent years, some marketing-based solutions have claimed to be taking this approach by segmenting patients into groups based on demographic factors or personality dimensions. The big problem is that these factors have not been proven to be strongly associated with adherence and even more critically, such an approach fails to identify and address the actual drivers of non-adherence.

During our 15 years of global clinical experience, we realise that the real world challenges faced by patients are far more complex and that patients vary hugely in their capability, opportunity and motivation for following prescribed treatments.

The message is simple: If we fail to recognise the need for personalised support strategies, we will never be able to provide truly effective interventions. This is why we need to get personal.