How do physicians and nurses assess and support patient medication adherence? An examination of a rural secondary care hospital in Delhi, India

Abstract

Introduction: Suboptimal medication adherence contributes enormously to patient mortality, morbidity, and related health-care costs. Health-care providers (HCPs) have a pivotal role in supporting medication adherence in their patients through appropriate health communication. We assessed the perspectives and practices of medical doctors and nurses toward the assessment and support for patient medication adherence in Indian health settings. Materials and Methods: We conducted a cross-sectional study at a secondary-care hospital in Delhi. Data were collected from medical doctors, interns, and nursing staff using a self-administered questionnaire on the following domains: Medication Adherence, frequency, methods and tools of assessment, high-risk patient identification and interventions applied to promote adherence. Results: We recruited a total of 117 HCPs. The common modes of assessment of medication adherence used by the HCPs included a general question (78.6%), observing missed appointments (43.6%), and querying for forgetfulness (29.9%). However, none of the HCPs were aware of validated questionnaire (scales) for the assessment of medication adherence. Drug-related adverse effects as a cause of nonadherence were evaluated by 38.3% HCPs only. Conclusions: The development of simple and validated methods for assessing medication adherence applicable in resource-constrained settings along with the curricular training of HCPs on patient adherence and related know-how needs urgent prioritization. The following core competencies are addressed in this article: Practice-based learning and improvement, Systems-based practice, and Interpersonal and communication skills.