Background:

Medication adherence is a significant challenge in chronic disease management, with only 50% of patients consistently following prescribed therapies. Despite the availability of effective treatments, poor adherence contributes to unmet health outcomes in general practice.

Research questions:

This study aimed to identify factors influencing medication adherence in general practice and explore strategies for improvement.

Method:

Semi-structured interviews were conducted with 18 patients, aged 23 to 92, from a rural general practice in Latvia, between December 2023 and January 2024. Participants had long-term medication prescriptions and/or a history of non-adherence. Thematic analysis was used to identify key themes.

Results:

Three main factors were identified. Self-medication was a significant issue, with many patients adjusting or discontinuing medications due to unmet treatment expectations, external advice, alcohol use, or side effects. Communication deficiencies between patients and healthcare providers were another barrier, with patients reporting unclear benefit of medication use. Medication management also emerged as a challenge, as patients often forgot to take medications or not carrying them to work or on a trip.

Conversely, factors promoting adherence included health literacy, perceived treatment benefits or risks of deterioration, and the use of medication management systems, both digital (reminder apps) and non-digital (pill organizers).

Conclusions:

Self-medication, communication barriers, and medication management issues significantly affect adherence. Improving patient education, fostering better communication, and providing tools to support medication management could enhance adherence and treatment outcomes.

Points for discussion:

How does self-medication affect patient adherence, and what strategies can healthcare providers use to address this issue?

How can health literacy be increased to support better medication management and adherence in general practice?