Preparing undergraduate pharmacists for practice: supporting patient adherence to medication

Abstract

Background: Up to 50% of medication for long-term conditions are not taken as prescribed and there is increasing emphasis on the role of the pharmacist in supporting adherence. The aim of this study was to design and evaluate a novel teaching programme to illustrate the challenges of taking daily medication. Methods: A mixed methods design to capture first-year students’ adherence to a one week ‘mock medicine’ activity (using Tic-Tacs™ sweets) with five different dosing regimens. School research ethics approval was obtained for thematic analysis of student feedback and calculation of percentage adherence. Mann-Whitney U and Kruskall Wallis tests were used to assess differences in adherence with regards to gender and dosing using SPSS v20©. Findings: Of the 115 students who took part, 76 (66%) returned a ‘diary proforma’ where 75% reported 80% or more adherence. There were no statistical differences in adherence for gender or dosing (from 1 to 4 times daily). Reasons for non-adherence were mainly related to unintentional (i.e. time of day, dosing schedule, day of week, convenience, routine, swallowing, taste, availability of medicine and tiredness). Resources such as setting phone alarms were utilised to overcome some of these barriers. Intentional reasons for non-adherence were low perceived importance and lack of symptoms. The value gained from this activity in empathising with patients was a strong emerging theme. Discussion: This teaching activity was successful in preparing students for their future roles in supporting patients in medicine-taking by providing them with the opportunity to ‘step in to the patient’s shoes’.