Ways Health Care Providers Can Promote Better Medication Adherence

Optimal diabetes management requires patient engagement in a variety of self-care activities, including adherence to medication regimens, adjustment to lifestyle modifications, and monitoring of blood glucose levels. Perhaps one of the most challenging self-care issues facing patients living with diabetes is that of medication adherence. Patients take their medication as prescribed only 50% of the time (1) and are reluctant to share the details of their less-than-optimal medication-taking behavior with their health care providers (HCPs) (2). In 2003, the World Health Organization stated that increasing medication adherence might have a far greater impact on the health of the population than any improvement in specific medical treatments (3). During the past 14 years, a better understanding of the barriers related to nonadherence has become more apparent. The following barriers have been consistently implicated in medication nonadherence for patients with diabetes: patients’ emotions, patients’ intention to not take medications, emotional distance from HCPs (e.g., because of HCPs’ poor understanding of the situation), social and cultural beliefs about health and antidiabetes medications, low health literacy, insufficient information about ancillary resources, medication complexity and lack of support or powerlessness to handle medication complexity, and poverty (4). Researchers have also documented the consequences of nonadherence, which include increased morbidity, mortality, and health care costs (5). Although the body of knowledge informing the issues of medication nonadherence has grown, the practical problem of medication adherence is one that patients and providers continue to struggle with on a daily basis. The National Diabetes Education Program developed a web resource titled “Promoting Medication Adherence in Diabetes,” available at www.niddk.nih.gov, to give HCPs evidence and tools to help them promote optimal medication-taking behavior among patients. To help busy HCPs, we have distilled the current knowledge base related to medication nonadherence in patients with diabetes into this practical …