Pharmacy students’ understanding and perceptions around medication adherence
Keywords:
Adherence Education, Australia, Medication Adherence, Pharmacy, StudentsAbstract
Background: Pharmacists can optimise patients’ medication adherence, hence pharmacy students should be acquiring professional competence to ensure they are prepared for their future professional role. Pharmacy curricula need to carefully address the concept of adherence.
Aim: To investigate undergraduate pharmacy students’ understanding and perceptions of medication adherence across the four years of the Pharmacy programme in an Australian school of pharmacy.
Method: Following piloting and ethical approval, a 20 statement electronic survey was distributed online to all undergraduate pharmacy students across four year levels. Students expressed their level of understanding and perceptions of ‘medication adherence’ on a 5-point Likert scale. The variation in mean responses across year levels and demographic groups was analysed using one-way ANOVA (p<0.05).
Results: Of the 858 students, 20.4% completed the survey. Students did not have comprehensive understanding of adherence, even though the majority (61.14%) felt confident regarding their ability to understand its causative factors. A non-significant variation in student responses was observed across year levels. Students considered ‘adherence education’ to be important for future practice.
Conclusion: Students’ understanding and perceptions around medication adherence did not vary significantly as they progressed through the degree. Suitable curriculum content around medication adherence could assist in optimising students’ preparedness for practice.
References
Adams, J. & McNab, N. (2013). Understanding arts and humanities students’ experiences of assessment and feedback. Arts and Humanities in Higher Education, 12(1), 36-52. doi: 10.1177/1474022212460743
Agh, T., Inotai, A. & Meszaros, A. (2011). Factors Associated with Medication Adherence in Patients with Chronic Obstructive Pulmonary Disease. Respiration, 82(4), 328. doi: 10.1159/000324453
Aslani, P. & Krass, I. (2009). Adherence: a review of education, research, practice and policy in Australia. Pharmacy Practice, 7(1), 1.
Barkhof, E., Meijer, C.J., De Sonneville, L.M.J., Linszen, D.H. & De Haan, L. (2012). Interventions to improve adherence to antipsychotic medication in patients with schizophrenia - A review of the past decade. European Psychiatry, 27(1), 9-18. doi:10.1016/j.eurpsy.2011.02. 005
Borgsteede, S.D., Karapinar-Çarkit, F., Hoffmann, E., Zoer, J. & van den Bemt, P.M.L.A. (2011). Information needs about medication according to patients discharged from a general hospital. Patient Education and Counseling, 83(1), 22-28. doi: 10.1016/j.pec.2010.05.020
Boyko, J.A. & Blackburn, D.F. (2011). Medication Adherence does not Appear to be a Clinical Priority among Community Pharmacists. Canadian Pharmacists Journal/Revue des Pharmaciens du Canada, 144(5), 216-219. doi: 10.3821/1913-701X-144.5.216
Briesacher, B.A., Andrade, S.E., Fouayzi, H. & Chan, K.A. (2008). Comparison of Drug Adherence Rates Among Patients with Seven Different Medical Conditions. Pharmacotherapy, 28(4), 437-443. doi: 10.1592/phco.28.4.437
Brown, M.T. & Bussell, J.K. (2011). Medication Adherence: WHO Cares? Mayo Clinic Proceedings, 86(4), 304-314. doi: 10.4065/mcp.2010.0575
Burkhart, P.V. & Sabaté, E. (2003). Adherence to long- term therapies: Evidence for action. Journal of Nursing Scholarship, 35(3), 207.
Cutrona, S.L., Choudhry, N.K., Stedman, M., Servi, A., Liberman, J.N., Brennan, T., Fischer, M.A., Brookhart, M.A. & Shrank, W.H. (2010). Physician Effectiveness in Interventions to Improve Cardiovascular Medication Adherence: A Systematic Review. Journal of General Internal Medicine, 25(10), 1090-1096. doi: 10.1007/ s11606-010-1387-9
Foreman, K.F., Stockl, K.M., Le, L.B., Fisk, E., Shah, S.M., Lew, H.C., Solow, B.K. & Curtis, B.S. (2012). Impact of a Text Messaging Pilot Program on Patient Medication Adherence. Clinical Therapeutics, 34(5), 1084-1091. doi: 10.1016/j.clinthera.2012.04.007
Geisel-Marbaise, S., Sonja, G.-M. & Harald, S. (2010). Diabetes adherence - does gender matter? Journal of Public Health, 18(3), 219-226. doi: 10.1007/ s10389-009-0305-2
Gupta, V., Hincapie, A.L., Frausto, S. & Bhutada, N.S. (2015). Impact of a web-based intervention on the awareness of medication adherence. Research in Social and Administrative Pharmacy. doi: 10.1016/j.sapharm. 2015.11.003
Haynes, B., Ann McKibbon, K. & Kanani, R. (1996). Systematic review of randomised trials of interventions to assist patients to follow prescriptions for medications. The Lancet, 348(9024), 383-386. doi: 10.1016/S0140- 6736(96)01073-2
Haynes, R.B., Ackloo, E., Sahota, N., McDonald, H.P. & Yao, X. (1999). Interventions for enhancing medication adherence. Cochrane Consumers and Communication Group (3). doi: 10.1002/14651858.CD000011.pub3
Hedegaard, U., Hallas, J., Ravn-Nielsen, L.V. & Kjeldsen, L.J. (2016). Process- and patient-reported outcomes of a multifaceted medication adherence intervention for hypertensive patients in secondary care. Research in Social and Administrative Pharmacy, 12(2), 302-318. doi: 10.1016/j.sapharm.2015.05.006
Hughes, C.M. (2004). Medication Non-Adherence in the Elderly. Drugs & Aging, 21(12), 793-811. doi: 10.2165/00002512-200421120-00004
Hugtenburg, J.G., Timmers, L., Elders, P.J. & Vervloet, M. (2013). Definitions, variants, and causes of non- adherence with medication: a challenge for tailored interventions. Patient Preference and Adherence, 7, 675-682. doi: 10.2147/PPA.S29549
Iihara, N., Nishio, T., Okura, M., Anzai, H., Kagawa, M., Houchi, H. & Kirino, Y. (2014). Comparing patient dissatisfaction and rational judgment in intentional medication non-adherence versus unintentional non- adherence. Journal of Clinical Pharmacy and Therapeutics, 39(1), 45-52. doi: 10.1111/jcpt.12100
Julius, R., Novitsky, M.A. & Dubin, W. (2009). Medication Adherence: A Review of the Literature and Implications for Clinical Practice, Journal of Psychiatric Practice, 15(1), 34-44.
Lewey, J., Shrank, W.H., Bowry, A.D.K., Kilabuk, E., Brennan, T.A. & Choudhry, N.K. (2013). Gender and racial disparities in adherence to statin therapy: a meta- analysis. American Heart Journal, 165(5), 665. doi: 10.1016/j.ahj.2013.02.011
Mai, A. & Aslani, P. (2007). Impact of Vietnamese written and verbal medicine information on Vietnamese-speaking Australians' knowledge and satisfaction. British Journal of Clinical Pharmacology, 64(4), 527-535. doi: 10.1111/j. 1365-2125.2007.02968.x
Mangan, M.N., Powers, M.F. & Lengel, A.J. (2013). Student Pharmacists’ Perceptions of Barriers to Medication Adherence Counseling. Journal of Pharmacy Practice, 26(4), 376-381. doi: 10.1177/089719001 2466896
Manteuffel, M., Williams, S., Chen, W. & Verbrugge, R.R. (2014). Influence of patient sex and gender on medication use, adherence, and prescribing alignment with guidelines. Journal of Women's Health (Larchmont, N.Y. 2002), 23(2), 112-119. doi: 10.1089/jwh.2012.3972
Mitchell, W.G., Scheier, L.M. & Baker, S.A. (2000). Adherence to treatment in children with epilepsy: who follows "doctor's orders"? Epilepsia, 41(12), 1616.
Mukhtar, O., Weinman, J. & Jackson, S.H.D. (2014). Intentional Non-Adherence to Medications by Older Adults. Drugs & Aging, 31(3), 149-157. doi: 10.1007/ s40266-014-0153-9
Nguyen, T.-M.-U., La Caze, A. & Cottrell, N. (2016). Validated adherence scales used in a measurement-guided medication management approach to target and tailor a medication adherence intervention: a randomised controlled trial. BMJ Open, 6(11). doi: 10.1136/ bmjopen-2016-013375
Nieuwlaat, R., Wilczynski, N., Navarro, T., Hobson, N., Jeffery, R., Keepanasseril, A., Agoritsas, T., Mistry, N., Iorio, A., Jack, S., Sivaramalingam, B., Iserman, E., Mustafa, R.A., Jedraszewski, D., Cotoi, C. & Haynes, R.B. (2014). Interventions for enhancing medication adherence. Cochrane Database of Systematic Reviews, (11). doi: 10.1002/14651858.CD000011.pub4
Oliveira, C.J.S., Neves, H.L., Sousa, J. & José, H. (2014). P170: What is the effect of an intervention in nursing to improve medication adherence in older people? A systematic review. European Geriatric Medicine, 5, S137. doi: 10.1016/S1878-7649(14)70345-6
Osterberg, L. & Blaschke, T. (2005). Adherence to Medication. New England Journal of Medicine, 353(5), 487-497. doi: 10.1056/NEJMra050100
Pringle, J.L., Boyer, A., Conklin, M.H., McCullough, J.W. & Aldridge, A. (2014). The Pennsylvania Project: pharmacist intervention improved medication adherence and reduced health care costs. Health Affairs (Project Hope), 33(8), 1444-1452. doi: 10.1377/hlthaff.2013.1398
Rickles, N.M., MacLean, L.G., Hess, K., Farmer, K.C., Yurkon, A.M., Ha, C.C., Schwartzman, E., Law, A.V., Milani, P.A., Trotta, K., Labella, S.R. & Designor, R.J. (2012). Teaching Medication Adherence in US Colleges and Schools of Pharmacy. American Journal of Pharmaceutical Education, 76(5), 79. doi: 10.5688/ ajpe76579
Ryan, R., Santesso, N., Lowe, D., Hill, S., Grimshaw, J., Prictor, M., Kaufman, C., Cowie, G. & Taylor, M. (2014). Interventions to improve safe and effective medicines use by consumers: an overview of systematic reviews. Cochrane Database of Systematic Reviews(4). doi: 10.1002/14651858.CD007768.pub3
Saleem, F., Hassali, M.A., Shafie, A.A., Ul Haq, N., Farooqui, M., Aljadhay, H. & Ahmad, F.U.D. (2015). Pharmacist intervention in improving hypertension-related knowledge, treatment medication adherence and health- related quality of life: a non-clinical randomized controlled trial. Health Expectations, 18(5), 1270-1281. doi: 10.1111/hex.12101
Spoelstra, S.L., Burhenn, P.S., Dekoekkoek, T. & Schueller, M. (2016). A trial examining an advanced practice nurse intervention to promote medication adherence and symptom management in adult cancer patients prescribed oral anti-cancer agents: study protocol. Journal of Advanced Nursing, 72(2), 409-420. doi: 10.1111/jan.12828
Stupans, I., McAllister, S., Clifford, R., Hughes, J., Krass, I., March, G., Qwen, S. & Woulfe, J. (2015). Nationwide collaborative development of learning outcomes and exemplar standards for Australian pharmacy programmes. International Journal of Pharmacy Practice, 23(4), 283-291. doi: 10.1111/ijpp.12163
The University of Queensland. (2016). The University of Queensland, Australia: PHRM2030 - Sem 1 2016 - St Lucia - Internal (online). Available at: http:// www.courses.uq.edu.au/student_section_loader.php? section=print_display&profileId=82885. Accessed 15th April, 2016.
Toklu, H.Z. & Hussain, A. (2013). The changing face of pharmacy practice and the need for a new model of pharmacy education. Journal of Young Pharmacists: JYP, 5(2), 38-40. doi: 10.1016/j.jyp.2012.09.001
Wang, X., Serna, O., Henges, C., Essien, E.J., Chung, N., Fleming, M. & Abughosh, S. (2015). PDB64 - Impact of a Pharmacist telephone Intervention on Preventing Medication discontinuation among Hypertensive Patients With Diabetes In a Medicare advantage plan. Value in Health, 18(3), A63-A64. doi: 10.1016/j.jval.2015.03.371
Willey, C., Redding, C., Stafford, J., Garfield, F., Geletko, S., Flanigan, T., Melbourne, K., Mitty, J. & Jaime Caro, J. (2000). Stages of change for adherence with medication regimens for chronic disease: Development and validation of a measure. Clinical Therapeutics, 22(7), 858-871. doi: 10.1016/S0149-2918(00)80058-2
