Improving medication adherence in patients with chronic diseases

Interventions to improve medication adherence tailored to the identified patient reasons for non-adherence. These interventions may include implementing dose administration aids, telephone reminders, health coaching or motivational interviewing. The selected intervention will depend on the patient's reasons for non-adherence. Dose administration aids as an intervention will be implemented by explaining to the patient what a dose administration aid looks like and how it works, which will take approximately 10 minutes. If the patient agrees the patient will be referred onto the pharmacy to initiate dose administration aids for this patient. The pharmacy will create a medication profile for the patient by liaising with the patient's general practitioner. The patient's prescriptions will be kept by the pharmacy and dispensed. Dose administration aids will be packed on a fortnightly basis and patients will pick up the packs as needed. (This is the standard procedure of dose administration aids in a pharmacy and the delivery of these packs will be the responsibility of the pharmacy). From the researcher's own experience in packing dose administration aids, the initiation of the dose administration aid will take several hours. Telephone reminders will be implemented by initiating fortnightly phone calls discussing medication-taking behaviour after baseline. Health coaching or motivational interviewing will involve setting goals of medication-taking behaviour, which will be conducted at baseline and 3 and 6 months if appropriate. This will be facilitated in the private counselling area of the pharmacy and will involve a 20 minute one-on-one interview with the researcher (who is also a pharmacist). These interventions will be implemented at baseline and if necessary 3 and 6 months after baseline. The interventions will be implemented over the total trial duration of 6 months.