Challenges and learnings of implementing a medication adherence service in clinical practice

Abstract

Background: There is mounting evidence that medication non-adherence is prevalent and associated with poor disease control, reduced quality of life and higher costs of healthcare. This emphasizes the need for effective adherence interventions. However, the embedding of these interventions in the daily workflow of care professionals is a major challenge. We developed an online service that assesses a patient’s adherence profile consisting of risks and barriers to non-adherence and provides profile-based intervention recommendations to health care professionals. The challenges and learnings from the implementation and use of the service in the daily workflow of pharmacists and nurse practitioners in primary care will be the focus of the presentation. Methods: Qualitative research methods were used to understand the experiences of patients and health care professionals with the service. In parallel, the effect of using this service on the adherence of starters with oral blood glucose lowering drugs or cardiovascular medication (N=875 in 15 pharmacies) is examined in a randomized controlled trial. Findings: The qualitative findings led to the identification of several challenges to implementing and using the service in daily practice. These were translated into specific recommendations for implementing adherence interventions in clinical practice. Discussion: In order to optimize the impact of the adherence intervention service, it is essential to carefully address the challenges with respect to implementation and use in daily clinical practice. The findings and recommendations contribute to the effective implementation of adherence interventions in clinical practice.