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NICE ideas on medicines compliance by patients published

This article was originally published in Scrip

The UK's National Institute for health and Clinical Excellence (NICE) has published a guideline for those who prescribe and dispense medicines to improve patient involvement in decisions about their treatments.

NICE says that between one third and one half of all medicines prescribed for long-term conditions are not taken as recommended, and suggests that this might represent a loss to patients, the healthcare system and society, with both personal and economic costs.

"Non-adherence should not be seen as the patient's problem," NICE says. It may represent a failure to fully agree the prescription in the first place or a failure to identify and provide the support that patients need later on.

Unintentional non-adherence might result from a patient's poor recall, difficulties in understanding instructions, problems with using the treatment, inability to pay for a prescription or simply forgetting to take it.

A patient's beliefs or preferences might lead to intentional non-adherence, NICE says. Prescribers and those dispensing prescription medicines need to take a "frank and open approach", a "no-blame approach" and a "patient-centred approach", the institute adds. Perceptions, practical problems and adherence may change over time.

Among dozens of recommendations, NICE advises healthcare professionals to accept that the patient has the right to decide not to take a medicine. They should recognise that "non-adherence is common and that most patients are non-adherent sometimes".

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