Collaboration for Academic Primary Care (APEx) Blog
Collaboration for Academic Primary Care (APEx) Blog
Posted by ma403
19 June 2024Non-adherence to medication is a “wicked” problem. Studies consistently report non-adherence rates of 50% or more particularly in people living with long-term chronic diseases. Non-adherence has been identified as a key target, for clinical interventions, for many years; I first learnt about it when I trained as a pharmacist over 30 years ago. Despite numerous policy initiatives and research studies it remains a challenge. If anything, it is getting worse perhaps as a consequence of a guideline disease specific approach to treatment and resulting polypharmacy.
Prior to moving to academia in 2012, I spent 20 years plus working in the NHS including community pharmacy, acute sector and mental health. My roles included clinical and managerial; I was chief pharmacist in two NHS Trusts. Since moving to academia, I have led six studies funded by the NIHR and UKRI mainly focused on medication optimisation and the role of community pharmacy. I have also been a co-applicant on numerous other studies.
My presentation builds on my clinical, leadership and research experience; plus my personal experience. I will aim to illustrate the challenge of non-adherence linked with my journey across multiple clinical areas and as an academic. Building on this experience, I will present the evidence from my research and wider.
The presentation will particularly focus on two areas: older people including those living with dementia, and mental health. I will discuss the findings from the NIHR MEMORABLE study and also the potential impact of anti-cholinergic burden. The second clinical area is mental health which presents unique adherence challenges. The presentation will focus on some of the underlying tensions and discuss recent research on medication optimisation, the NIHR MEDIATE study, and managing anti-psychotic weight gain, the NIHR RESOLVE study. Partly building on direct personal experience, one key focus will be the role of Family carers.
Finally, the presentation will offer practical solutions on how we can start to address this “wicked” problem of non-adherence and areas for future research.