Pharmacy students’ reflections on a ‘mock medicines’ activity: Exploring intentional and unintentional non- adherence

Efthymia Mantzourani, Georgia Potter-Floyd, Delyth James


Objective: To engage pharmacy students in a ‘mock medicines’ teaching activity to increase their understanding of the patients’ perspectives of medicine-taking. To explore students’ awareness of intentional reasons for non-adherence.

Methods:Students were given one of five different dosing regimes and asked to take the mock medicine (TicTacs©) over a one-week period. They completed a data capture form to log each dose taken or missed and provide reasons for this. An adherence score was calculated and all feedback transcribed for further analysis.

Results: Seventy-six out of 115 students submitted forms, where adherence ranged from 4 to 100% (mean 88.7, SD=19.77). Nine factors relating to unintentional non-adherence were identified compared to only one for intentional non-adherence.

Conclusions: Students engaged well with this activity showing a high percentage adherence but this was not related to the complexity of dosing schedule. Students demonstrated more awareness of the unintentional reasons for non- adherence than intentional. 


Patient Perspectives, Intentional Non-adherence, Unintentional Non-adherence, Mock Medicines, Pharmacy Undergraduate Education

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Abdel-Tawab, R., James, D.H., Fichtinger, A., Clatworthy, J., Horne, R. & Davies, J.G. (2011). Development and validation of the medication-related consultation framework (MRCF). Patient Education and Counseling, 83(3), 451-7.

Caldeira, D., Vaz-Carneiro, A. & Costa, J. (2014). The Impact of dosing frequency on medication adherence in chronic cardiovascular disease: systematic review and meta-analysis. Revista Portuguesa de Cardiologia, 33(7-8), 431-437.

Chen, J.T., LaLopa, J. & Devra, D.K. (2008). Impact of patient empathy modelling on pharmacy students caring for the undeserved. American Journal of Pharmaceutical Education, 72(2),40:1-11.

Darbishire, P.L., Plake, K.S., Kiersma, M.E. & White, J.K. (2012). An introductory pharmacy practice experience on improving medication adherence. American Journal of Pharmaceutical Education, 76(3), 42:1-8.

Donovan, J.L. & Blake, D.R. (1992). Patient non- compliance: deviance or reasoned decision-making? Social Science & Medicine, 34(5), 507-513.

Divine, H.S. & Cain, J. (2009). Assessing the effect of a polypharmacy medication adherence simulation project in a geriatrics course in a college of pharmacy. Journal of the American

Geriatric Society, 57(8), 1487–1491.

Eisner, E.W. (1982). Cognition and curriculum: a basis for deciding what to teach. New York: Longman.

Fernandes, M., Leite, A., Basto, M. ,Nobre, M.A., Vieira, N., Fernandes, R., Nogueira, P. & Nicola, P.J. (2014). Non-adherence to antibiotic therapy in patients visiting community pharmacies. International Journal of Clinical Pharmacy, 36(1), 86-91.

Horne, R. (2006). Beliefs and adherence to treatment: the challenges for research and clinical practice. In The Power of Belief Psychological Influences on Illness, Disability and Medicine (eds. P. Halligan & M. Aylward), Oxford University Press, United States, pp.115-135.

Horne, R. (2000). Non-adherence to medication: causes and implications for care. In A Behavioural Approach to Pharmacy Practice (ed. P. Gard), Blackwell Science Ltd., Oxford, pp.111-130.

James, D., Nastasic, S., Horne, R. & Davies, G. (2001). The design and evaluation of a simulated-patient teaching programme to develop the consultation skills of undergraduate pharmacy students. Pharmacy World & Science, 23(6), 212-216.

Kardas, P. (2002). Patient compliance with antibiotic treatment for respiratory tract infections. Journal of Antimicrobial Chemotherapy, 49, 897–903.

McDonough, R.P. & Bennett, M.S. (2006). Improving communication skills of pharmacy students through effective precepting. American Journal of Pharmaceutical Education, 70(3), 58:1-12.

NICE [National Institute for Health and Clinical Excellence], (2009). Quick reference guide 'Medicines adherence', NICE clinical guideline 76 (online). Available at: guidance/cg76. Accessed 23rd June, 2016.

O'Connor, D.M., Savageau, J.A., Centerbar, D.B., Wamback, K.N., Ingle, J.S. & Lomerson, N.J. (2009). Lesson in a pill Box: teaching about the challenges of medication adherence. Family Medicine, 41(2), 99-104.

Payer, J., Killinger, Z., Sulkova, I. & Celec, P. (2008). Preferences of patients receiving bisphosphonates- how to influence the therapeutic adherence. Biomedicine & Pharmacotherapy, 62(2), 122-124.

Reginster, J.Y., Rabenda, V. & Neuprez, A. (2006). Adherence, patient preference and dosing frequency: understanding the relationship. Bone, 38(4 Supp. l1), S2– S6.

Schwartz, B. & Bohay, R. (2012). Can empathy help teach professionalism and empathy to dental students? Adding patient videos to a lecture. Journal of Dental Education, 76(2), 174-184.

Shapiro, J. (2002). How do physicians teach empathy in the primary care setting? Academic Medicine, 77(4), 323-328.

Ulbrich, T., Hamer, D. & Lehotsky, K. (2012) Second- year pharmacy students’ perceptions of adhering to a complex simulated medication regimen. American Journal of Pharmaceutical Education, 76(1), 11.


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