Working With Patients to Enhance Medication Adherence

H elping patients take medications effectively is a key clinical undertaking. Optimal medication adherence improves clinical outcomes and can even lower health care costs by reducing morbidity and decreasing health care use.1 Benefits are especially striking in patients with diabetes.2,3 Across chronic illnesses, patients take only ∼ 50% of medications prescribed for those conditions.4,5 Similar patterns are seen in patients with diabetes,6 particularly in those who also have depressive symptoms. Among depressed patients with diabetes, for example, nonadherence to hypoglycemic and antihypertensive agents is even lower than among nondepressed patients with diabetes.7,8 Even among nondepressed patients, levels of medication adherence may be significantly lower than desired because of side effects and lack of motivation to take the medications as prescribed. Figure 1. Sample preprinted label. Photo courtesy of J. Dudl, Kaiser Permanente Care Management Institute for Diabetes. Patients, health care providers, and health care systems all play a role in creating this quality and outcome gap between current reality and optimal diabetes management.9,10 Barriers to effective use of medicines for diabetes care include: 1 ) poor provider-patient communication; 2 ) inadequate knowledge about a drug and its use (in both patients and clinicians); 3 ) psychological insulin …