After using the MMAS-8 (Morisky Medication Adherence Scale-8) to assess a patient's adherence, it's important to ask questions to better understand the specific reasons behind intentional or unintentional non-adherence. The five dimensions of non-adherence can serve as a framework for educational counseling. Here are some questions you might ask:
1. **Social and Economic Factors**:
- "Are there any financial concerns or insurance issues that make it difficult for you to obtain your medication?"
- "Do you have a support system to help you remember and take your medication as prescribed?"
2. **Healthcare System and Healthcare Team Factors**:
- "Have you experienced any difficulties in obtaining your prescription from the pharmacy or any issues with your healthcare provider?"
- "Do you feel comfortable discussing concerns or side effects with your healthcare team?"
3. **Condition-Related Factors**:
- "How well do you understand your medical condition and the importance of your medication in managing it?"
- "Have you experienced any side effects or other issues with your medication?"
4. **Patient-Related Factors**:
- "What is your daily routine like, and how do you currently manage taking your medication within that routine?"
- "Do you have any concerns or doubts about the efficacy or safety of your medication?"
5. **Therapy-Related Factors**:
- "Are there any specific challenges you face in following the dosing schedule or instructions for your medication?"
- "Do you prefer one medication form (e.g., tablets, liquid) over another, and does that affect your adherence?"
By asking questions related to these dimensions, you can pinpoint the underlying reasons for non-adherence and tailor your educational counseling to address the specific issues the patient is facing. This approach can help improve medication adherence and overall patient outcomes.
Dr Donald Morisky.