medicines quick

medicines quick

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Quick reference guide
Issue date: January 2009
Medicines adherence
Involving patients in decisions about prescribed medicines
and supporting adherence
NICE clinical guideline 76
Developed by the National Collaborating Centre for Primary Care

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Medicines adherence Contents
Introduction 4
Patient-centred care 4
Key principles 5
Involving patients in decisions about medicines 6
Supporting adherence 8
Reviewing medicines 9
Improving communication between healthcare 9
Implementation tools 10
Further information 11
© National Institute for Health and Clinical Excellence, 2009. All rights reserved. This material may be
freely reproduced for educational and not-for-profit purposes. No reproduction by or for commercial
organisations, or for commercial purposes, is allowed without the express written permission of NICE.…read more

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Why don't some patients use their
Medicines adherence medicines as prescribed?
Why don't some patients use their
medicines as prescribed?
They don't want to They have practical
(intentional non- problems
adherence) (unintentional
What can be done about this?
Improve communication
with patients (see page 6)
Increase patient
involvement in decision-
making (see page 6)
Involve patients in
decisions about
Increase understanding
of patient's perspective
(see page 7)
Provide information
(see page 7)
Assess adherence
Support adherence
(see page 8)
Review medicines
(see page…read more

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Medicines adherence Patient-centred care
Between a third and a half of medicines1 that are prescribed for long-term conditions are not used as
recommended. This represents a health loss for patients and an economic loss for society.
Non-adherence should not be considered the patient's problem. Rather, it usually results from a failure
to fully agree the prescription with the patient in the first place and to support the patient once the
medicine has been dispensed.…read more

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Medicines adherence Key principles
Key principles
G Healthcare professionals should adapt their consultation style to the needs of individual patients so
that all patients have the opportunity to be involved in decisions about their medicines at the level
they wish.
G Establish the most effective way of communicating with each patient and, if necessary, consider
ways of making information accessible and understandable (for example, using pictures, symbols,
large print, different languages, an interpreter or a patient advocate).…read more

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Involving patients in decisions
Medicines adherence about medicines
Involving patients in decisions about medicines
Improving communication
Good communication is needed for involving patients in decisions about medicines. Some patients
find it more difficult than others to communicate with healthcare professionals.…read more

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Involving patients in decisions
Medicines adherence about medicines
Understanding the patient's perspective
Patients sometimes make decisions about medicines based on their understanding of their
condition and possible treatments, their view of their need for the medicine and their concerns.…read more

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Medicines adherence Supporting adherence
Supporting adherence
Assessing adherence
Healthcare professionals are not always aware when patients don't use their medicines as
prescribed. Assessing adherence is not about monitoring patients but rather finding out whether
patients need more information and support. You should routinely assess adherence in a non-
judgemental way whenever you prescribe, dispense and review medicines.…read more

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Reviewing medicines
Medicines adherence Improving communication between
healthcare professionals
Reviewing medicines
Patients may use medicines long term. The initial decision to prescribe medicines, the patient's
experience of using the medicines and the patient's needs for adherence support may change over
time and should be reviewed regularly.
G Offer repeat information and review, especially when treating long-term conditions with
multiple medicines.
G Review at agreed intervals patients' knowledge, understanding and concerns about medicines
and whether they think they still need the medicine.…read more

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Medicines adherence Implementation tools
Implementation tools
NICE has developed tools to help organisations G Guide to resources ­ gives information about a
implement this guidance (listed below). selection of resources available from NICE,
These are available on our website government and other national organisations
( G Patient information resource ­ an information
G National costing statement ­ gives some sheet for display in healthcare settings
financial background and context to the G Audit support for monitoring local practice.…read more


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