Interventions to improve adherence

  • Simplify Rx regimen: The most effective strategy.
    • ↓ Pill burden and dosing frequency.
    • Use once-daily dosing or fixed-dose combination pills.
  • Patient education & counseling:
    • Provide individualized, repeated education.
    • Employ behavioral techniques like motivational interviewing.
  • Reminders & feedback:
    • Use electronic reminders (texts, apps, smart pill bottles).
    • Provide feedback on clinical outcomes (e.g., BP, HbA1c).
  • Team-based care:
    • Involve pharmacists (e.g., medication synchronization).
    • Utilize a multidisciplinary approach, especially for pts with polypharmacy.
  • Reduce financial barriers:
    • Decrease or eliminate copayments and out-of-pocket costs.
  • Address psychosocial factors:
    • Screen for and address low health literacy.
    • Involve the patient’s social support system (family, friends).

Adolescents

  • Lack of support, stigmatization (especially amongst adolescents, e.g., due to peer attitudes toward the illness and/or its treatment)
    • Peer-facilitated behavioral interventions to convey knowledge about the illness and social acceptance for its treatment
      • Encourage patients with chronic illnesses to seek support from peers with the same chronic illness, e.g., through:
        • Community health projects
        • Local and online support groups
    • Encourage patients with chronic illnesses to familiarize their peers with their illness and its treatment.