Non-adherence, drug-related problems and negative outcomes associated with medication: causes and outcomes in drug therapy follow-up

Authors

  • E GARCÍA-JIMÉNEZ PhD, PharmD. Grupo de Investigación en Atención Farmacéutica de la Universidad de Granada (España).
  • P AMARILES PhD, PharmD. Profesor de Farmacia Clínica y Farmacología de la Facultad de Química Farmacéutica, Universidad de Antioquia, Colombia. Grupo de Investigación Promoción y Prevención Farmacéutica, Universidad de Antioquia (Colombia).
  • M MACHUCA PhD, PharmD. Farmacéutico comunitario. Grupo de Investigación en Farmacoterapia y Atención Farmacéutica de la Universidad de Sevilla (España).
  • M PARRAS-MARTÍN PhD, PharmD. Grupo de Investigación en Atención Farmacéutica de la Universidad de Granada (España).
  • J ESPEJO-GUERRERO PhD, PharmD. Farmacéutico comunitario. Grupo de Investigación en Atención Farmacéutica de la Universidad de Granada (España).
  • MJ FAUS PhD, PharmD. Profesor Facultad de Farmacia, Universidad de Granada (España). Grupo de Investigación en Atención Farmacéutica de la Universidad de Granada (España). Dirección: Campus de Cartuja S/N, Granada

Keywords:

Pharmacotherapy follow-up, Negative Outcomes Associated with Medication, Drug-related problem, Nonadherence, Pharmacist’s intervention, Dader Program, Dader Method

Abstract

Background: non-adherence continues being an issue of discussion in Pharmaceutical Care, due to the fact that someresearches consider non-adherence as a drug related problem (DRPs) and others ones as cause of Negative OutcomesAssociated with Medication (NOMs). Thus, we believe that is import to add elements to this discussion, from the perspectiveof the pharmacotherapy follow-up (PTF).

Method: a cross sectional analysis of Pharmacist’s interventions on NOMs associated to non-adherence recorded inthe Dader Program of PTF of the University of Granada, from January 1st of 2000 to July 31st of 2002. Interventionswere included.

Results: In total 4485 NOMs were recorded in the Dader program, from January 1st of 2000 to July 31st of 2002.Among this group, an association between the health problems and non-adherence was found in 702 (15.6%) NOMs.The mean (SD) number of prescriptions per identifi ed NOM was of 5.5 (3.2). Chronic health problems were associatedto lack of adherence, conversely the acute health problems were associated to excess of use of medication. If the 3central activities in health assistance (structure, process and clinical outcomes), are complemented with the practice ofthe pharmacotherapy follow-up this allows the identifi cation and differentiation among the NOMs (outcomes) and theDRPs (failure in the process of medication use that causes NOM, e.g., non-adherence).

Conclusion: In this study, non-adherence is associated with 15.6% of NOMs. In view of PTF using the Dader Method,non-adherence is an important cause of NOM.

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References

Düsing R, Lottermoser K, Mengden T. Compliance with drug therapy- new answers to old question. Nephrol Dial Transplant 2001; 16:1317-1321.

Balkrishnan R. The Importance of Medication Adherence in Improving Chronic-Disease Related Outcomes. What We Know and What We Need to Further Know. Med Care 2005;2005:517-520.

Vermeire E, Hearnshaw H, Van Royen P. Patient adherence to treatment: three decades of research. A comprehensive review. J Clin Pharm Ther 2001; 26:331-342.

Cotter G, Shemesh E, Zehavi M, et al. Lack of aspirin effect: Aspirin resistance or resistance to taking aspirin? Am Heart J 2004;147:293-300.

Schwartz KA, Schwartz DE, Ghosheh K, Reeves MJ, Barber K, DeFranco A. Compliance as a Critical Consideration in Patients Who Appear to Be Resistant to Aspirin After Healing of Myocardial Infarction. Am J Cardiol 2005; 95:973-975.

Morris AD, Boyle DIR, McMahon Alex, Greene SA, MacDonald TM, Newton RW. Adherence to insulin treatment, glycaemic control, and ketoacidosis in insulin-dependent diabetes mellitus. Lancet 1997; 350:1505-1510.

Mikhail SW, Kennedy HG. Homicide, novel antipsychotics, and non-compliance (letter). Lancet 2000; 355:1189.

Balkrishnan R, Rajagopalan R, Camacho FT, Huston SA, Murray FT, Anderson RT. Predictors of Medication Adherence and Associated Health Care Costs in an Older Population with Type 2 Diabetes Mellitus: A Longitudinal Cohort Study. Clin Ther 2003; 25:2958-2971.

Cleemput I, Kesteloot K. Economic implications of non-compliance in health care. Lancet 2002; 359:2129-2130.

Organización Mundial de la Salud. El papel del farmacéutico en el sistema de atención de salud. Informe de la Reunión de la Organización Mundial de la Salud. Tokio (Japón) Septiembre 1993. Pharm Care Esp 1999; 1:207-211.

American Society of Hospital Pharmacists. ASHP statement on pharmaceutical care. Am J Hosp Pharm 1993; 50:1720-1723.

Tabor PA, Lopez D. Comply With Us: Improving Medication Adherence. Journal of Pharmacy Practice 2004; 17:167-181.

World Health Organization. Adherence to long-term therapies. Evidence for action. WHO publications. 2003.

Murray MD, Morrow DG, Weiner M, et al. A Conceptual Framework to Study Medication Adherence in Older Adults. Am J Geriatr Pharmacother 2004; 2:36-43.

Comite de Consenso. Third Consensus of Granada on Drug Related Problems (DRP) and Negative Outcomes associated with Medication (NOM). Ars Pharm 2007; 48: 5-17.

Research Group on Pharmaceutical Care. Dader Method to provide pharmacotherapy follow up. Ars Pharm 2005; 46:309-335.

Sabater Hernández D, Silva Castro MM, Faus MJ. Método Dáder: Guía de Seguimiento Farmacoterapéutico. Tercera Edición 2007. Grupo de Investigación en Atención Farmacéutica. Granada. 2007. Disponible en: www.atencionfarmaceutica-ugr.es

Martínez-Romero F, Fernández-Llimós F, Gastelurrutia MA, Parras M, Faus MJ. Pilot phase results of the Dáder programme for drug therapy follow up. Ars Pharm 2001; 42:53-65.

García Caudevilla M, García Jiménez E, Tena M, Urbón A. Drug-Therapy follow up in pharmacies, by the Aragón Official Pharmacists Association (I). The implementation of the Dáder Method. Pharm Care Esp 2002; 4:231-241.

Fernández-Llimós F, Faus MJ, Gastelurrutia MA, Baena MI, Martínez-Martínez F. Systematic identification of negative clinical outcomes from Pharmacotherapy. Seguim Farmacoter 2004; 2:195-205.

Martín-Calero MJ, Machuca M, Murillo MD, Cansino J, Gastelurrutia MA, Faus MJ. Structural Process and Implementation Programs of Pharmaceutical Care in Different Countries. Current Pharmaceutical Design 2004; 10:3969-3985.

Fernández-Llimós. Resultados del Programa Dáder: 5 años. Mesa redonda: Proyección internacional que está teniendo el seguimiento farmacoterapéutico. Seguimiento Farmacoterapéutico 2005; 3(supl 1):11-14.

Donabedian A. The quality of care: how can it be assessed. JAMA 1988; 260:1743-748.

Strand LM, Morley PC, Cipolle RJ, Ramsey R, Lamsam GD. Drug-related problems: their structure and function. Ann Pharmacother 1990; 24:1093-1097.

van Mil JW, Westerlund LO, Hersberger KE, Schaefer MA. Drug-related problem classification systems. Ann Pharmacother 2004; 38: 859-67.

FORO de Atención Farmacéutica. Documento de Consenso. Madrid. 2008. Disponible en: www.atencionfarmaceuticaugr.es

Anonymous (2004) ATC Index with DDD´s Oslo: WHO Collaborating Centre for Drug Statistic Methodology.

Blackwell B. Drug therapy compliance. N Eng J Med 1973; 289:249-252.

Snider De, Castro KG. The global threat of drug-resistant tuberculosis. N Engl J Med 1998; 338:1689-1690.

Eisen SA, Miller DK, Woodwar RS et al. The effect of prescribed daily dose frequency on patient medication compliance. Arch Intern Med1990; 150:1881-1884.

Vanderpoel DR, Hussein MA, Watson-Heidari T, Perry A. Adherence to a fixed-dose combination of rosiglitazone plaleate/pletformin hydrochloride in subjects with type 2 diabetes Mellitus: A retrospective database analysis. Clin Ther 2004; 26:2066-2075.

Chapman RH, Benner JS, Petrilla AA, el al. Predictors of Adherence With Antihypertensive and Lipid-Lowering Therapy. Arch Intern Med 2005; 165:1147-1152.

Richter A, Anton SE, Koch P, Dennett SL. The Impact of reducing dose frequency on health outcomes. Clin Ther 2003; 5:2307-2335.

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Published

2008-06-20

How to Cite

1.
GARCÍA-JIMÉNEZ E, AMARILES P, MACHUCA M, PARRAS-MARTÍN M, ESPEJO-GUERRERO J, FAUS M. Non-adherence, drug-related problems and negative outcomes associated with medication: causes and outcomes in drug therapy follow-up. Ars Pharm [Internet]. 2008 Jun. 20 [cited 2024 Nov. 20];49(2):145-57. Available from: https://revistaseug.ugr.es/index.php/ars/article/view/4918

Issue

Vol. 49 No. 2 (2008)

Section

Original Articles

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