Overcoming Barriers to Medication Adherence: Helping Patients with Knowledge-Based Gaps

January 17, 2019 Jenny Glennon


A pharmacist helping to close a patient's medication knowledge gap

This is the third installation of our “Overcoming Barriers to Medication Adherence” blog series. Read our introductory blog post to learn the common characteristics of medication non-adherence and how to identify the patient-level barriers to adherence.

It’s no wonder that a gap in knowledge is a primary cause of medication non-adherence.

According to an analysis conducted by Health Dialog, approximately 11% of patients may not be adherent to their prescriptions because of knowledge gaps.  Prescription labels and instructions with a great deal of clinical information can be confusing and sometimes overwhelming for patients. Health literacy is often limited; nine out of 10 adults struggle to understand and use health information (CDC). Oftentimes, providers don’t have adequate time during a routine visit to provide details about medication benefits and the importance of taking them correctly.

Knowledge gaps can derive from a variety of unique patient scenarios:

  • What if the patient doesn’t speak English and no one takes the time to inform him or her about how to use a medication properly?
  • What if the patient’s cultural background lends to a mistrust of doctors and he or she doesn’t believe the medication is really necessary?
  • What if the physician uses jargon-filled language and the patient is too embarrassed to admit they don’t understand it?
  • What if the patient is fearful of their condition and doesn’t ask the right questions because they’re afraid to know the answers?
  • What if the patient takes many other medications and doesn’t know how to fit “another pill” into their daily regimen?

In order to overcome knowledge gaps in medication adherence, the patient care team must:

  • Assess a patient’s health literacy
  • Identify the knowledge gaps a patient has regarding their medication(s)
  • Clearly address the purpose, correct use and benefits of taking medication and consequences of non-adherence with simple, jargon-free language
  • Involve patients in the medication decision-making process to sustain long-term behavior change
  • Provide awareness about proper disease state management with health education tools, including online and printed information
  • Discuss concerns about medication side effects in a straightforward manner
  • Take into consideration cultural differences and social determinants  that might impact medication-taking behavior

Closing Knowledge Gaps Can Improve Medication Adherence: A Patient Case Study

Personalized health coaching services provide the opportunity to identify and close knowledge gaps and for patients to have their medication-related questions answered (outside of the office visit). It also helps to demystify what can often be very complex medication directions or regimens. In addition to educational materials, coaches provide connections to other resources that work best for each patient to help overcome barriers to adherence.

One of our Health Coaches, Valerie, recently reached out to a patient named Pam because she was starting a new statin. Pam was formally diagnosed with diabetes after a few years of having slightly-elevated blood sugar readings. Her doctor sent her home with a written prescription for Simvastatin, but Pam never filled it. She had seen several TV commercials discussing statins and their side effects. She had questions about the medication that came to her mind after she left her appointment and didn’t think that her cholesterol was really high enough to justify taking another medication. 

Valerie called Pam and was able to uncover why she had not yet filled the prescription. She educated Pam on the benefits of statin use for people with diabetes and sent her some educational material about statin use specific to people with diabetes. Valerie also helped her formulate some questions to ask her provider about statin use like: “Would a statin drug be safe for me to take?” and “Do I need to take a statin even though my cholesterol is not high?”  Upon closing the call, Pam agreed to further discuss the Simvastatin prescription with her provider at her next visit the following week.

Hear what Pam had to say after her first conversation with a health coach:

 “I’m supposed to be taking a new drug, which I hadn’t started yet. I just have a lot of questions and Valerie called and went over so many different things with me: the pluses of taking the medication regularly and what to look for. She was very clear, easy-to-understand, and very patient with all my hundreds of questions.” - Pam

Valerie followed up with Pam the day after her appointment and was able to confirm that Pam did indeed fill her statin prescription after talking further about it with her doctor. Valerie also scheduled a follow-up call in one month to check in with Pam and see how she was doing with taking her statin medication. 

With Health Dialog’s personalized health coaching, Valerie was able alleviate Pam’s fears about taking a statin medication and help Pam address her concerns with her provider.

Understanding how each individual in your population is impacted by barriers like knowledge gaps is critical to improving medication adherence results and reducing healthcare costs. Learn more about how our health coaches can improve medication adherence.

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