Improving Patient Compliance

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Improving Patient Compliance

• By Kate Thorndike
• Specialist Transplant Pharmacy Technician
  MAPharmT

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Introduction

• What is my role?
• Can you define patient compliance and the issues
  affecting it?
• How are we improving patient compliance in
  Transplant?
• How can we use this in practice?

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Definition

• Compliance The extent to which patients take
  medicines according to the prescribed
  instructions
• Adherence The extent to which the patients
  behaviour matches agreed recommendations from the
  prescribers
• Concordance Shared decision making about
  medicines between a Healthcare Professional and a
  patient, based on partnership, where the
  patients expertise and beliefs are fully valued
• Weiss M and Britten N, Pharmaceutical Journal vol
  271 (493)
• Concordance, adherence and compliance in medicine
  taking. Report for the National Co-ordinating
  Centre for NHS Service Delivery Oragnisation R
  and D (NCCSDO) 2005

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Why Compliance?

• Transplant medications are vital to stop
  rejection and organ loss therefore patients must
  follow prescribers recommendations or they may
  lose their organ and in some cases their lives

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Factors affecting patient groups

• Taking medication
• Timing of doses/consistency
• Change to doses
• Side effects
• Drug holidays
• Brand
• Language
• Eyesight

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Improving compliance post Transplant

• Drug education understanding medication
• Aids dossette boxes, mobile phone alerts, smart
  phone apps
• Clinic sessions Young Adults Transplant Service
• Follow up - contact information

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Group Activity

• Using the patient medication sheet and material
  provided think about how you would present this
  new medication regimen to a transplant patient
• What information would you highlight for the
  patient?
• How would you present it to the patient?

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Patients Medication Sheet in TransplantPatient
Counselling sheet designed by Bridget
Featherstone Lead Pharmacist in Transplant
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Patient Medication Sheet in Transplant Patient
Counselling sheet designed by Bridget
Featherstone Lead Pharmacist in Transplant
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How do I use this technique?

• Every new transplant patient is given a
  medication sheet specific to their drug regimen
• Using these sheets, every patient is counselled
  to ensure thorough and correct understanding of
  why and how to take their medication
• Once discharged I run an outpatient clinic to
  highlight other important lifestyle changes
• My contact details are provided on the medication
  sheets so patients can contact me with any
  queries regarding medication once discharged

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An audit of Medicines Adherence on the Transplant
Unit at Addenbrookes Hospital

• In January 2009 the National Institute of Health
  and Clinical Excellence (NICE) published guidance
  on Medicines Adherence. In June 2012 the
  Transplant Unit at Addenbrookes Hospital
  conducted an audit on New solid organ transplant
  patients to assess the level of patient
  education given to aid adherence.
• 25 people over 18 participated.
• OBJECTIVES
• Do these patients receive adequate and
  appropriate verbal and written information
  related to their medicines?
• Do these patients clearly understand the
  information provided to them?
• Do these patients have opportunities to raise
  concerns and if so, were they addressed
  appropriately?
• STANDARDS
• 1, 100 of the patients receive adequate and
  appropriate verbal and/or written information
  related to their medicines
• 2, 100 of the patients clearly understand the
  information provided to them
• 3, 100 of the patients have opportunities to
  raise concerns.
• 4, 100 of the patient concerns were addressed
  appropriately

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An audit of Medicines Adherence on the Transplant
Unit at Addenbrookes Hospital
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Medicines Optimisation WE can make a
difference

• The role of a Specialist Pharmacy Technician
• Understanding patient compliance and the issues
  affecting it
• Improving patient compliance
• Educating and supporting patients on their
  medication

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Thank you!

• Kate Thorndike
• Specialist Transplant Pharmacy Technician
  MAPharmT
• Cambridge University Hospitals NHS Foundation
  Trust
• Addenbrookes Hospital
• Hills Road
• Cambridge
• CB2 0QQ
• Email Kate.thorndike_at_addenbrookes.nhs.uk
• Tel No 01223 216055