It is thought that between a third and a half of all medicines1
There are many causes of non-adherence but they fall into two overlapping categories: intentional and unintentional. Unintentional non-adherence occurs when the patient wants to follow the agreed treatment but is prevented from doing so by barriers that are beyond their control. Examples include poor recall or difficulties in understanding the instructions, problems with using the treatment, inability to pay for the treatment, or simply forgetting to take it. prescribed for long-term conditions are not taken as recommended. If the prescription is appropriate, then this may represent a loss to patients, the healthcare system and society. The costs are both personal and economic. Adherence presumes an agreement between prescriber and patient about the prescriber’s recommendations. Adherence to medicines is defined as the extent to which the patient’s action matches the agreed recommendations. Non-adherence may limit the benefits of medicines, resulting in lack of improvement, or deterioration, in health. The economic costs are not limited to wasted medicines but also include the knock-on costs arising from increased demands for healthcare if health deteriorates. Non-adherence should not be seen as the patient’s problem. It represents a fundamental limitation in the delivery of healthcare, often because of a failure to fully agree the prescription in the first place or to identify and provide the support that patients need later on. Addressing non-adherence is not about getting patients to take more medicines per se. Rather, it starts with an exploration of patients’ perspectives of medicines and the reasons why they may not want or are unable to use them. Healthcare professionals have a duty to help patients make informed decisions about treatment and use appropriately prescribed medicines to best effect

Medicines adherence: Involving patients in decisions about prescribed medicines and supporting adherence

Background
Health management is impeded when consumers do not possess adequate knowledge about their illness. At a public health level, consumer knowledge about depression is particularly important because depression is highly prevalent and causes substantial disability and burden. However, currently little is known about the information needs of people with depression. This study aimed to investigate the explicit and implicit information needs of users of an online depression support forum.

/pdf/explicit-and-implicit-information-needs-of-people-with-ujtvgdvlsb.pdf

Explicit and implicit information needs of people with depression: a qualitative investigation of problems reported on an online depression support forum

Although a number of articles about pharmacy practices in European countries have been published, few reviews compare pharmacy and pharmaceutical care practices throughout Europe.1,2 In 2000 the status of pharmaceutical care in Europe was discussed in a Spanish journal,3 and in 2004 two other reviews were published.4,5 A series of articles on the development of pharmaceutical care and pharmacy practice in a number of countries is now being published in the Annals of Pharmacotherapy.6 But these articles describe one country at a time, and the series will only cover a limited number of European countries.7,8,9,10 There are several reasons why it is difficult to get a clear picture of pharmacy and pharmaceutical care practices in Europe. Although the European Union (EU) has now existed for many years, there has yet to be any harmonization in the field of primary health care even though a number of recommendations have been made.11 As a result, there still are major differences in health care policies and practices among European countries. Furthermore, it is not very common to describe current practices or professional developments in pharmacy; most articles focus on commercial and professional threats to pharmacy or future challenges. It is somewhat easier to find articles describing research into small elements of pharmacy practice; but in most European countries even this research is not yet normal practice. There are many different pharmacy journals in Europe, but they are published in over forty different languages and many are not indexed in major international databases like Medline/Pubmed. In this literature review, we aim to describe contemporary European developments regarding the implementation of and research into pharmaceutical care, focusing on the community pharmacy. We will identify the major

https://www.cff.org.br/userfiles/106%20-%20VAN%20MIL,%20Harvard_%20A%20Review%20of%20Pharmaceutical%20Care%20in%20Community%20Pharmacy%20in%20Europe.pdf

A Review of Pharmaceutical Care in Community Pharmacy in Europe

Purpose The aim of this study was to 1) describe drug information desired by patients and 2) analyze how such information could be customized to be presented to patients according to their individual information needs. Materials and methods We performed a scoping literature search and identified relevant drug information topics by assessing and clustering 1) studies analyzing patients' enquiries to drug information hotlines and services, and 2) qualitative studies evaluating patient drug information needs. For the two most frequently mentioned topics, we further analyzed which components (ie, information domains) the topics contained and examined patients' and health care professionals' (HCPs) views on these components. Results Of 27 identified drug information topics in the literature search, patients most frequently requested information on adverse drug reactions (ADRs) and drug-drug interactions (DDIs). Hypothetically, those topics are composed of seven distinct information domains each (eg, ADR and DDI classification by frequency, severity, or onset; information on management strategies, monitoring, and prevention strategies). Patients' and HCPs' appraisal concerning the information content of these domains varies greatly and is even lacking sometimes. Conclusion Patients particularly request information on ADRs and DDIs. Approaches to customize such information are sparse. The identified information domains of each topic could be used to structure corresponding drug information and to thus facilitate customization to individual information needs.

/pdf/how-to-meet-patients-individual-needs-for-drug-information-a-4f3ki677bl.pdf

How to meet patients' individual needs for drug information - a scoping review

Purpose To explore risk perception and medicines information needs in pregnant women with epilepsy (WWE). Method In-depth interviews with pregnant WWE treated with antiepileptic drugs (AEDs). Results Ten women aged 22–39 years in 20–34 weeks' gestation were interviewed. Avoiding seizures by taking AEDs in pregnancy outweighed perceived risks, but dose adjustments during and after pregnancy increased perceived risks of teratogenicity or seizures. The women had restrictive attitudes towards taking medicines for other indications than epilepsy. They appreciated their neurologist as a source for medicines information, though their needs for medicines information were reduced by long-term use of AEDs. Conclusions Pregnant WWE were confident in using AEDs through communication with their neurologist, but dose adjustments caused concern. Medicines information to pregnant WWE should focus on empowering the women to control the disease, supporting realistic risk perceptions of AEDs and other necessary medicines. In this article, we outline some medicines information strategies to pregnant WWE.

Risk perception and medicines information needs in pregnant women with epilepsy--a qualitative study.

Promoting therapy adherence requires understanding various psychosocial parameters, including patients’ need for information. Drug information adapted to patients’ needs may empower them and increase their confidence in drug therapy. Objectives: To explore psychiatric in-patients’ information preferences and to test the reliability of a Dutch version of the Intrinsic Desire for Information (IDI) scale in psychiatric institutions in Flanders. Standardised interviews were conducted with psychiatric patients in 11 hospitals. The interview consisted of the IDI-scale and five open questions. Patient demographics collected were sex, age, number of medicines taken, diagnosis, number of admissions during the past year, marital status, education level and occupation. 279 patient interviews were completed. A factor analysis on the original 12-item scale yielded 3 factors. An abbreviated scale was derived from the first factor (F1). This 6-item scale measured ‘extent of information desired:’ (EID) and consisted of six items (Cronbach’s α = 0,73). A second factor (F2) measured ‘information provider preference’ (IPP) (α = 0,56) and a third factor (F3) measured ‘inhibited information desire’ (IID) (α = 0,69). EID was associated with number of medicines taken, duration of hospitalisation and marital status. The internal reliability of the EID-factor appears to be reproducible in the specific setting of psychiatric hospitals. It may be useful to help healthcare professionals develop pharmaceutical care towards psychiatric patients. Validation of the scale remains to be completed. Information need in psychiatric in-patients measured by the EID-score was comparable to the need measured in general hospitals during earlier research in England. Targeted information services seem to be desirable to enhance therapy adherence and quality of life in psychiatric patients.

Desire for information about drugs: a survey of the need for information in psychiatric in-patients.

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Desire for information about drugs: a survey of the need for information in psychiatric in-patients.