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CONTINUING PROFESSIONAL DEVELOPMENT
therefore gain benefit from the use of
the aid(s). The adherence aid(s) should
also be tailored to the patient’s needs
and affordability and pharmacists can
assist the patient with selection based
on these factors. For example, if the
cause of non-adherence is forgetting to
take medicine, then an alarm or timer
is likely to be more beneficial than a
DAA. Once an adherence aid has been
selected, the use of the aid can be
reviewed over a number of weeks to
ensure that the patient has obtained
benefit from it and that the benefit
is ongoing. If no improvement has
occurred or improvement has not been
maintained, another adherence aid can
be suggested and trialled.
The PSA has a number of documents
available to assist with DAAs and
assessment of non-adherence at:
Although DAAs can improve a patient’s
adherence to taking medicine, in
Peter’s case it has not. You and Peter
discuss the use of the DAA and the
issues he is having with it. In doing so
you discover that he is unhappy with
the number of tablets he is required
to take. Together, you decide that a
simplified dosage regimen may be more
appropriate for Peter and you contact
his doctor to discuss this.
KEY LEARNING POINTS
• Poor adherence significantly impacts
on the ability to control medical
conditions and has the potential
for numerous adverse outcomes
including hospital admission.
• There are a variety of adherence
• Choice of adherence aid should
involve the patient and should be
chosen according to patient needs.
• Ongoing monitoring and review
of the adherence aid is necessary
to ensure benefit is obtained and
1. Aronson JK. Compliance, concordance, adherence. Br J Clin
Pharmacol. 2007;63(4):383–4 .
2. World Health Organisation. Adherence to long-term
therapies: evidence for action. Geneva, Switzerland: WHO;
3. Ryan R, Santesso N, Hill S, et al. Consumer-oriented
interventions for evidence-based prescribing and
medicines use: an overview of systematic reviews.
Cochrane Database of Systematic Reviews 2011, Issue 5.
Art. No.: CD007768. DOI: 10.1002/14651858.CD007768.
4. MacLaughlin EJ, Raehl CL, Treadway AK, et al. Assessing
medication adherence in the elderly: which tools to use in
clinical practice? Drugs Aging 2005;22(3):231–55 .
5. Bourbeau J, Bartlett SJ. Patient adherence in COPD. Thorax.
6. Elliott RA. Appropriate use of dose adminstration aids. Aust
7. Morisky DE, Green LW, Levine DM. Concurrent and
predictive validity of a self-reported measure of medication
adherence. Med Care 1986;24(1):67–74.
8. Haynes RB, Ackloo E, Sahota N, et al. Interventions for
enhancing medication adherence. Cochrane Database of
Systematic Reviews 2008, Issue 2. Art. No.: CD000011. DOI:
9. Atreja A, Bellam N, Levy SR. Strategies to enhance patient
adherence: making it simple. MedGenMed 2005;7(1):4.
10. Osterberg L, Blaschke T. Adherence to medication. N Engl J
11. Vervloet M, Linn AJ, van Weert JCM, et al. The effectiveness
of interventions using electronic reminders to improve
adherence to chronic medication: a systematic review of
the literature. J Am Med Inform Assoc 2012;19(5):696–704.
12. Dayer L, Heldenbrand S, Anderson P, et al. Smartphone
medication adherence apps: potential benefits to patients
and providers. J Am Med Inform Assoc 2013;53(2):172–81.
13. NPS MedcineWise. MedicineList+ smartphone app. 2014.
14. Australian Pharmaceutical Advisory Council. Guiding
principles for medication management in the community.
Canberra: APAC; 2006.
1. Which ONE of the following is least
likely to contribute to medicine
a) Complex medicine administration
b) Adequate health literacy.
c) Lack of understanding of efficacy of
d) Medicine adverse effects.
2. Before recommending a dose
administration aid (DAA), which
other action(s) can be taken to
a) Simplifying the medicine regimen.
b) Providing a list of patient medicines.
c) Avoiding services such as Home
Medicines Reviews (HMRs).
d) All of the above.
3. Which patients may benefit from
the use of a dose administration aid
a) Patients with a complex medicine
b) Forgetful patients.
c) Patients with a lack of motivation in
regards to taking medicine.
d) All of the above.
4. Which information can the
pharmacist collect to assess the
suitability of an adherence aid?
a) Factors influencing non-adherence.
b) Affordability of the adherence aid.
c) Patient acceptability of the adherence
d) All of the above.
SUPPORTING PHARMACY PRACTICE
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