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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…

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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…

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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…

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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…

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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. You can improve
communication by:

G adapting your consultation style…

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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.
You can improve your understanding of the patient's perspective by:


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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…

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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…

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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 ­…


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