Medication adherence has received a great deal of attention over the

Medication adherence has received a great deal of attention over the past several decades; however its definition and measurement remain elusive. skills. Taking prescribed medicine has long been recognized as one of the most essential self-care activities performed by patients to promote their health. Medication non-adherence is estimated to cost the U.S. health care system more than $100 billion annually and is linked to more than 125 0 deaths each year (Bosworth et al. 2011 Ernst & Grizzle 2001 As prescription drug use in the United States continues to rise the salience of promoting safe appropriate medication use will only become even more important from a public health perspective (Gu Dillon & Burt 2010 Gaining a concrete understanding of patient roles and responsibilities in outpatient settings is necessary to develop and implement comprehensive strategies to support these behaviors. Although medication adherence has received an unprecedented amount of attention over the past several decades its definition and measurement continue to remain elusive (Andrade Kahler Frech & Chan 2006 Cramer et al. 2008 Farmer 1999 Haynes et al. 2005 Osterberg & Blaschke 2005 Debates over the correct terminology to use to describe related behaviors are common (Cramer et al. 2008 Steiner & Earnest 2000 As a result its measurement is definitely often challenging cumbersome and expensive (Farmer 1999 As a result adherence is typically operationalized as a limited set of behaviors such as filling a prescription or taking doses of a medication. This emphasis offers over time simplified the way we think of medication use and offers directed attention away from the varied series of methods a patient must take to self-manage medications in ambulatory care and attention (Osterberg & Blaschke 2005 BMN673 Simplistic conceptualizations of medication use have become even more problematic as individuals are increasingly becoming prescribed multiple medications BMN673 (Gu et al. 2010 To take these multidrug regimens safely and appropriately individuals must engage in a number of behaviors that vary in difficulty and require an even greater knowledge and skill set (Wolf Curtis et al. 2011 Herein we propose a new definition of medication use that is guided by relatively recent yet extensive evidence that has emerged from your field of health literacy. Specifically we introduce a new conceptual model that deconstructs the jobs associated with taking prescription drugs including the knowledge skills and behaviors necessary for individuals to correctly take medications and to sustain proper use over time in ambulatory care. The field of health literacy in its entirety offers made invaluable contributions to BMN673 this particular topic of study inquiry and to the broader mission of understanding the cognitive and psychosocial demands that are placed on individuals as a result of performing Rabbit Polyclonal to POU4F3. requisite health behaviors. “Unintentional Nonadherence”: The Part of Health Literacy Evidence suggests that and to define it as “the degree to which a patient takes medication as prescribed including not only BMN673 the correct dose rate of recurrence and spacing but also its continued safe use over time.” Considering this definition it is possible to deconstruct to identify the series of steps a patient must take to safely and efficiently take their medications in ambulatory care (see Number 1). Because the focus of this model is definitely on outpatient settings the model begins after the physician encounter and assumes that the patient has been prescribed a medication that they are responsible for self-administering. Number 1. Model of medication self-management. (Color number available on-line.) Step 1 1: Fill After the physician encounter the first step that individuals must take to self-manage their Rx routine is to fill and pick up their prescription. Evidence suggests that this step is often not taken because approximately a quarter (24%) of prescriptions for fresh medications are never stuffed (Fischer et al. 2011 Fischer et al. 2010 Drug cost poor understanding of why the drug is necessary and fear of negative effects have been cited as potential root causes of this trend; poor provider-patient communication is likely to lead to misunderstandings (Dimatteo 2004 Golin DiMatteo & Gelberg 1996 Kennedy Tuleu & Mackay 2008 Furthermore with the recent implementation of e-prescribing individuals are less likely to get tangible reminders of fresh medications such as a written prescription on a prescriber’s pad. With fewer prompts individuals may be actually less likely to fill fresh electronically prescribed medications.