Open AI has just announced how to create a GPT agent. In the realm of healthcare, understanding and addressing patient adherence is crucial for successful treatment outcomes. Health care providers have an invaluable tool in the Morisky Medication Adherence Scale (MMAS-8) to identify intentional non-adherence among patients.

The MMAS-8 is a self-report measure that assesses a patient's adherence to medications. It delves into the patient's behavior, identifying intentional non-adherence – instances where patients consciously decide not to adhere to prescribed treatments. By utilizing this scale, healthcare providers can pinpoint areas of concern and tailor interventions to improve adherence.

Once the GPT agent identifies intentional non-adherence which is often multifaceted. Mental health plays a pivotal role, and depression can significantly impact a patient's ability to adhere to medical recommendations. Enter the Collaborative Study of Depression (CUDOS) scale, a reliable instrument for assessing depression.

The GPT agent can strategically implement the CUDOS scale to explore the potential link between depression and non-adherence. By identifying depressive symptoms, providers gain insights into the patient's mental health, recognizing a crucial dimension of adherence that extends beyond the physical aspect.

The GPT agent then can target motivational interviewing questions from the patient-related dimension of non-adherence. Depression can manifest as a barrier to following prescribed treatments, with symptoms like fatigue, lack of motivation, and diminished interest in activities contributing to intentional non-adherence. Recognizing this interplay between mental health and adherence is pivotal for a holistic approach to patient care.

Medication adherence is a critical aspect of managing chronic conditions and ensuring the effectiveness of prescribed therapies. The Morisky Medication Adherence Scale, often referred to as the Morisky 8-Item Scale or MMAS8, is a widely used tool to assess medication adherence in patients.

Within this scale, two specific questions, Questions 4 and 6, delve into the therapy-related dimension and indirectly address aspects of pharmacokinetics.

The Morisky 8-Item Scale is a self-report instrument that helps healthcare professionals evaluate a patient's adherence to medication regimens. It consists of eight questions, with 4 questions addressing the intentional and 4 questions addressing the unintentional domains of non adherence, further, the questions are designed to assess different dimensions of medication adherence, including the therapy-related dimension, which encompasses various factors related to the patient's perception and understanding of their medication therapy.

Question 4: "When you travel or leave home, do you sometimes forget to bring your medications with you?"

This question is “unintentional”, and touches on the therapy-related dimension and has implications for pharmacokinetics. When a patient forgets to take their medication while traveling or leaves their medications behind, it can disrupt the dosing schedule and affect the drug's pharmacokinetics. Pharmacokinetics refers to how drugs are absorbed, distributed, metabolized, and excreted in the body. Missing a dose, especially for medications with a short half-life, can lead to fluctuations in drug concentration in the bloodstream and potentially reduce therapeutic efficacy. This question highlights the importance of consistent medication intake to maintain optimal pharmacokinetic profiles.

Question 6: "When you feel like your symptoms are under control, do you sometimes stop taking your medication?”

Question 6 is “intentional” and delves even deeper into the therapy-related dimension and has significant implications for pharmacokinetics. When patients alter their medication dose without consulting a healthcare provider, they may intentionally disrupt the intended pharmacokinetics of the drug. Some medications have specific dosing regimens to achieve desired therapeutic levels, and modifying these doses can lead to overmedication, undermedication, or other adverse effects. Such alterations can impact how the drug is absorbed, distributed, and metabolized in the body, potentially jeopardizing the intended pharmacokinetic parameters that ensure treatment efficacy and safety.

The Therapy-Related Dimension and Pharmacokinetics

The therapy-related dimension of medication adherence encompasses various factors, including patients' understanding of their medications, their willingness to follow prescribed regimens, and their perception of the importance of medication therapy. Both Question 4 and Question 6 of the Morisky 8-Item Scale are valuable in assessing this dimension.

When patients forget to bring their medications while traveling (Question 4) or alter their medication dose independently (Question 6), they may not fully grasp the pharmacokinetic implications of their actions. This lack of awareness can lead to suboptimal treatment outcomes, increased healthcare costs, and potentially adverse health effects.

Conclusion

The Morisky 8-Item Scale is a valuable tool for healthcare professionals to assess medication adherence, including the therapy-related dimension. While it may not directly ask about pharmacokinetics, questions such as Question 4 and Question 6 indirectly address this crucial aspect of medication management. By identifying issues related to forgetfulness and self-dosing, healthcare providers can intervene, educate patients, and help them maintain consistent medication regimens, ultimately improving treatment efficacy and patient well-being while ensuring the desired pharmacokinetic outcomes.

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.

The Moriskyscale MMAS4 and MMAS8, or Morisky Medication Adherence Scales, are a trusted and validated tool pharmaceutical companies, such as Jannsen, Abbvie, Opis, Merk, Pfizer, etc. use for developing and testing new medications. A critical aspect of ensuring the success of these medications is understanding patient adherence to prescribed regimens during clinical trials.

The Moriskyscale MMAS4 and MMAS8:
The Moriskyscale, developed by Dr. Donald E. Morisky is a validated tool designed to assess medication adherence. It is particularly relevant in clinical trials, where adherence is crucial for accurate evaluation of a medication's safety and efficacy. The MMAS4 and MMAS8 are two variations of the scale, each serving specific purposes.

Assessing Medication Adherence
- The MMAS4: This abbreviated version includes four simple questions that provide a quick assessment of adherence. It measures both intentional and unintentional non-adherence.
- The MMAS8: A more comprehensive version, it consists of eight questions that delve deeper into the domains and dimensions of medication non-adherence.

Domains and Dimensions of Medication Non-Adherence:

Intentional Non-Adherence This domain deals with patients deliberately choosing not to follow their medication regimens for various reasons. It can be attributed to personal beliefs, fears of side effects, or a desire to stop medication once symptoms improve.

Unintentional Non-Adherence Unintentional non-adherence encompasses patients missing doses or not adhering to their regimens due to external factors such as forgetfulness, lack of understanding, or complicated dosing instructions.

5 Dimensions of Medication Non-Adherence:

Healthcare-Related Factors Patients may be non-adherent because of a lack of communication with healthcare providers or insufficient support and education regarding their medications.

Socioeconomic-Related Factors Economic constraints, limited access to healthcare, or transportation issues can impact a patient's ability to adhere to their medication plan.

Patient-Related Factors Personal beliefs, attitudes, and mental health can significantly influence medication adherence. Understanding patient perspectives is crucial in addressing these issues.

Medication-Related Factors The complexity of medication regimens, side effects, and perceived effectiveness can all affect adherence. Some patients may discontinue medication if they experience undesirable side effects or lack perceived benefits.

Therapy-Related Factors The patient's overall experience with the therapy, including its convenience, efficacy, and any difficulties encountered, can determine whether they adhere to the prescribed regimen.

How Pharmaceutical Companies Use Moriskyscale MMAS4 and MMAS8:

Screening Participants
Prior to enrolling patients in clinical trials, pharmaceutical companies often use the Moriskyscale to identify potential non-adherence issues. This helps in selecting a more representative study population.

Measuring Adherence During Trials
The scales are employed to continuously monitor adherence throughout the trial. This data helps to account for adherence in the analysis of the medication's effectiveness.

Understanding Reasons for Non-Adherence
By using the MMAS8, pharmaceutical companies can delve into the specific domains and dimensions contributing to non-adherence. This information can guide targeted interventions.

Improving Medication Regimens
Insights from the Moriskyscale may lead to adjustments in medication regimens or the development of support programs to enhance adherence.

The Morisky 8-Item Scale is a widely used tool for assessing medication adherence among patients. One of the key aspects it aims to evaluate is the patient's perception of their health condition. Question 6 of the Morisky 8-Item Scale specifically explores whether individuals occasionally stop taking their medication(s) when they believe their health condition is under control. This blog post delves into how question 6 can be employed to determine the condition-related domain and its significance in assessing medication adherence.

​Question 6: When you feel like your health condition is under control, do you sometimes stop taking your medication(s)?

Understanding Question 6:
Question 6 of the Morisky 8-Item Scale is designed to gauge the relationship between patients' perception of their health condition and their medication adherence. It specifically addresses situations where individuals might cease taking their medication(s) when they believe their health condition is under control. This question serves as a crucial indicator to assess the patient's understanding, beliefs, and behavior toward their condition and medication regimen.

Determining the Condition-Related Domain:
Question 6 offers insights into the condition-related domain by revealing potential patterns or tendencies of patients to discontinue their medication(s) once they perceive their health condition to be adequately managed. This domain focuses on the patient's perception of control over their condition and how it influences their medication adherence.

Importance of the Condition-Related Domain:
Risk Evaluation: The condition-related domain sheds light on patients who may be at risk of non-adherence due to their belief that medication is unnecessary when their health condition appears stable. This insight helps healthcare providers identify individuals who may require additional education and support to maintain consistent medication usage.

Treatment Adjustment: Patients who intermittently stop taking their medication(s) when they believe their health condition is under control may experience fluctuations in their health status. Recognizing such behavior allows healthcare professionals to reassess the treatment plan and consider adjustments to medication dosage, frequency, or additional interventions to better manage the patient's condition.

Patient Education: Understanding patients' beliefs and behaviors regarding their health condition is essential for effective patient education. By identifying those who stop medication when they feel their condition is controlled, healthcare providers can tailor educational interventions to address misconceptions, emphasize the importance of continuous medication use, and provide rationale behind adherence guidelines.

Adherence Improvement: Recognizing the condition-related domain helps healthcare professionals design interventions that promote sustained medication adherence. By addressing patients' concerns, providing clear explanations, and reinforcing the significance of adherence even during perceived stability, healthcare providers can enhance patient engagement and foster long-term adherence habits.

Question 6 of the Morisky 8-Item Scale serves as a valuable tool in determining the condition-related domain within medication adherence assessments. It allows healthcare professionals to understand how patients' perceptions of control over their health condition influence their adherence behaviors. By leveraging this information, healthcare providers can devise targeted strategies to improve adherence, optimize treatment plans, and enhance patient outcomes. Understanding the significance of this domain is essential in promoting effective patient care and management of chronic conditions.

Achieving optimal treatment outcomes relies on maintaining medication adherence. To assess medication adherence, several scales are available. In this blog, we will compare three commonly used scales: the Morisky 8-Item Scale, the Brief Medication Questionnaire (BMQ), and The Hill-Bone Compliance Scale. Let's explore the advantages of each scale to help you make an informed decision.

1. Morisky 8-Item Scale:

- Provides a comprehensive assessment of adherence
- Simple and straightforward for patients and healthcare professionals
- Extensively validated and reliable
- Culturally adaptable
- Supported by research evidence
- Helps identify specific barriers to adherence
- Minimizes self-reporting bias
- Considers forgetfulness, timing, and dosage instructions

The Morisky 8-Item Scale offers a comprehensive evaluation of medication adherence, covering various aspects such as forgetfulness, timing, and dosage instructions. It is user-friendly and has been extensively validated, ensuring its reliability. The scale is culturally adaptable and supported by research evidence. Moreover, it helps identify specific barriers to adherence and minimizes self-reporting bias, enhancing the accuracy of results.

2. Brief Medication Questionnaire (BMQ):

- Assesses patient beliefs and concerns
- Identifies perceived barriers to adherence
- Validated in diverse populations
- Useful for exploring patient perspectives
- Quick to administer

The BMQ focuses on patient beliefs, concerns, and perceived barriers related to medication adherence. It provides insights into patient perspectives and identifies potential barriers. The scale has been validated in diverse populations and is a convenient tool for assessing medication adherence efficiently.

3. The Hill-Bone Compliance Scale:

- Assesses medication-taking behavior
- Validated for hypertensive patients
- Includes multiple subscales
- Provides an overall adherence score
- Sensitive to different adherence levels

The Hill-Bone Compliance Scale evaluates medication-taking behavior and offers an overall adherence score. It has been specifically validated for hypertensive patients and includes multiple subscales, allowing a comprehensive assessment. The scale's sensitivity to different adherence levels enhances its ability to capture variations in adherence behaviors.

When selecting a medication adherence scale, it is essential to consider specific research or clinical needs, patient characteristics, and desired outcomes. The Morisky 8-Item Scale stands out as a comprehensive, validated, and culturally adaptable tool that addresses forgetfulness, timing, and dosage instructions. The BMQ offers insights into patient beliefs and concerns, while The Hill-Bone Compliance Scale focuses on medication-taking behavior and provides an overall adherence score.

Medication adherence is a critical factor in ensuring positive health outcomes for patients. However, socio-economic barriers can significantly impact an individual's ability to consistently take their medications as prescribed. Healthcare providers can utilize specific questions from the Morisky 8-Item Scale, such as Question 2 and Question 5, to delve into the socio-economic domain and gain insights that can inform personalized interventions to improve medication adherence.

Question 2: People sometimes miss taking their medications for reasons other than forgetting. Thinking over the past 2 weeks, were there any days when you did not take your medication(s)?

The socio-economic domain is closely tied to Question 2 of the Morisky 8-Item Scale. This question aims to identify the reasons behind medication non-adherence beyond forgetfulness. By exploring this aspect, healthcare providers can uncover various socio-economic barriers that patients may encounter.

Financial constraints often play a significant role in medication non-adherence. Patients may struggle to afford the prescribed medications due to limited financial resources or lack of insurance coverage. Healthcare providers can utilize Question 2 to assess whether patients are facing financial difficulties that hinder their ability to adhere to their medication regimen. If financial constraints are identified, providers can collaborate with patients to explore alternative options, such as assistance programs, generic substitutions, or lower-cost alternatives.

Transportation and accessibility challenges can also impact medication adherence. Some patients may face difficulties in accessing pharmacies, particularly in rural areas or regions with limited public transportation. By considering Question 2, healthcare providers can identify whether transportation barriers contribute to medication non-adherence. Providers can then work with patients to develop strategies, such as home delivery services or local pharmacy partnerships, to overcome these challenges.

Question 5: Did you take your medication(s) yesterday?

Question 5 of the Morisky 8-Item Scale focuses on assessing medication adherence on the previous day. This question provides healthcare providers with valuable insights into a patient's recent medication-taking behavior and potential socio-economic influences.

Socio-economic factors can affect an individual's ability to take their medication consistently, even in the short term. For example, work-related constraints, such as irregular work schedules or demanding job responsibilities, may hinder patients from adhering to their medication regimen. By exploring Question 5, healthcare providers can uncover such challenges and tailor interventions accordingly. Flexible dosing schedules, reminders, or support from employee assistance programs may be considered to address work-related barriers to medication adherence.

Moreover, socio-economic factors can impact patients' ability to afford medications on a day-to-day basis. Patients may skip doses due to financial constraints, particularly when faced with competing expenses. By evaluating responses to Question 5, healthcare providers can identify potential financial struggles that lead to intermittent medication non-adherence. Providers can then collaborate with patients to explore financial assistance programs, discuss cost-effective alternatives, or connect them with resources that can alleviate their financial burden.

Conclusion:
Utilizing questions from the Morisky 8-Item Scale, specifically Question 2 and Question 5, healthcare providers can gain valuable insights into the socio-economic domain and its impact on medication adherence. By addressing socio-economic barriers, such as financial constraints and accessibility challenges, providers can work collaboratively with patients to develop personalized interventions that enhance medication adherence. Taking a holistic approach to patient care, considering the socio-economic factors influencing medication adherence, can lead to improved health outcomes and a more patient-centered healthcare experience.

The Morisky 8-Item Scale is a widely used tool in the field of healthcare and medication adherence research that aims to assess an individual's adherence to prescribed medication regimens. Among the eight questions that comprise the scale, one question stands out for its unique affirmative nature: "Did you take your medication(s) yesterday?" What is the reasons behind the affirmative format of this question and discuss its significance in medication adherence assessment?

Understanding the Affirmative Format:
The affirmative format of question 5, "Did you take your medication(s) yesterday?" is distinctive because it deviates from the typical questioning style employed in the Morisky 8-Item Scale. The other seven questions in the scale are phrased in a negative or neutral manner, making this particular question stand out.

Reasons for the Affirmative Format:
1. Simplicity and Clarity: The affirmative format of question 5 offers a straightforward and unambiguous response expectation. Participants are asked to provide a simple "yes" or "no" answer, making it easier to understand and respond to compared to negatively framed questions.

2. Positive Response Bias: By phrasing the question in an affirmative manner, the scale encourages participants to disclose instances of medication adherence. This approach reduces the likelihood of response bias, where participants may be more inclined to answer negatively to avoid admitting non-adherence.

3. Direct Assessment of Recent Behavior: The question specifically targets medication intake on the previous day. This time frame ensures a more immediate assessment of adherence behavior, enhancing the accuracy of the results obtained from the scale.

Significance of Question 5:
1. Sensitivity to Non-Adherence: The affirmative format of question 5 allows for a better identification of individuals who may be non-adherent to their medication regimens. Since it avoids negative framing that might lead to underreporting, this question provides a valuable opportunity to detect patients who might require additional support or interventions to improve medication adherence.

2. Monitoring Short-Term Adherence: As the only question on the Morisky 8-Item Scale that focuses on recent medication intake, question 5 offers a means to monitor short-term adherence behavior. This can be particularly useful in clinical settings where monitoring adherence patterns over shorter periods is crucial, such as postoperative recovery or acute treatment phases.

Question 5 of the Morisky 8-Item Scale breaks the mold with its affirmative format, setting it apart from the other questions. By adopting this unique style, the scale achieves simplicity, reduces response bias, and enables a direct assessment of recent medication adherence behavior. The affirmative nature of this question proves to be significant in capturing non-adherence and monitoring short-term medication intake accurately. Its inclusion in the Morisky 8-Item Scale adds valuable insights to medication adherence research and clinical practice, aiding in the development of interventions to improve patient outcomes.

The Morisky 8-Item Scale is a commonly used tool in healthcare to assess medication adherence among patients. Within this scale, Questions 3 and 8 provide valuable insights into the therapy-related domain. In this blog post, we will delve into these two questions, examining their significance and how they contribute to understanding patients' adherence to therapy and medication.

Question 3: "Have you ever cut back or stopped taking your medication(s) without telling your doctor because you felt worse when you took it?"

Question 3 of the Morisky 8-Item Scale aims to assess patients' behavior of adjusting or discontinuing their medication without consulting their doctor due to experiencing worsened symptoms. This question sheds light on patients' self-management practices and their inclination to modify their medication regimen based on perceived negative effects. It is crucial for healthcare providers to understand this behavior to address potential medication non-adherence and ensure patient safety. By recognizing patients' concerns and misconceptions about medication effects, healthcare professionals can provide appropriate education and guidance to promote adherence and mitigate potential risks.

Question 8: "How often do you have difficulty remembering to take all your medication(s)? Never/Rarely, Once in a while, Sometimes, Usually, All the time."

Question 8 explores the frequency of patients experiencing difficulty in remembering to take their medication. This question provides insights into patients' adherence challenges related to forgetfulness. Understanding the frequency of forgetfulness helps healthcare providers assess the level of support required for patients to improve adherence. It enables them to implement strategies such as reminders, medication organizers, or other aids to enhance patients' ability to remember and take their medication as prescribed.

Importance of Questions 3 and 8 in Therapy Adherence:

1. Identifying Medication Non-Adherence:
- Question 3 helps healthcare professionals identify instances where patients adjust or discontinue their medication without consulting their doctor. By recognizing this behavior, healthcare providers can intervene to address potential non-adherence and educate patients about the importance of open communication regarding medication adjustments. This fosters a collaborative approach to therapy and enhances patient safety.

2. Addressing Patient Concerns and Misconceptions:
- Question 3 provides an opportunity for healthcare providers to address patients' concerns and misconceptions about medication effects. By providing appropriate education and clarifying potential misunderstandings, healthcare professionals can improve patients' understanding of their medication and empower them to make informed decisions regarding their therapy.

3. Tailoring Interventions for Adherence:
- Question 8 highlights the frequency of forgetfulness in medication adherence. Understanding patients' difficulties in remembering to take their medication allows healthcare providers to tailor interventions accordingly. Strategies such as reminders, medication organizers, or digital tools can be implemented to support patients in adhering to their prescribed medication regimen, ultimately improving therapy outcomes.

Questions 3 and 8 of the Morisky 8-Item Scale play a crucial role in understanding patients' therapy adherence and medication management. By addressing patients' behaviors related to adjusting medication without consultation and assessing the frequency of forgetfulness, healthcare providers can tailor interventions to improve adherence and address patient concerns. This leads to enhanced therapy outcomes, increased patient safety, and improved overall patient care. Understanding these aspects of the therapy-related domain is key to optimizing the effectiveness of medication regimens and promoting better patient outcomes.

Medication adherence plays a crucial role in ensuring the effectiveness of medical treatments. However, studies have shown that a significant number of individuals experience difficulties in adhering to their prescribed medication regimens. To shed light on this important topic each question of the morisky scale is designed to uncover the distinction between intentional and unintentional medication non-adherence, offering valuable insights for both patients and healthcare providers.

1. Do you sometimes forget to take your medication(s)?
This question primarily addresses unintentional medication non-adherence. Forgetting to take medications can occur due to a lapse in memory or a lack of established routines. It is an unintentional act that may negatively impact treatment outcomes.

2. People sometimes miss taking their medications for reasons other than forgetting. Thinking over the past two weeks, were there any days when you did not take your medication(s) ?

This query focuses on intentional non-adherence. It prompts individuals to reflect on specific instances where they may have missed taking their medication(s) altogether for reasons other than forgetting, providing an indication of potential adherence challenges.

3. Have you ever cut back or stopped taking your medication(s) without telling your doctor because you felt worse when you took it?
This question addresses intentional medication non-adherence. It uncovers instances where patients consciously choose to modify or discontinue their medication(s) without consulting their healthcare provider. Patients may perceive their medication(s) as worsening their condition or experience undesirable side effects, leading to intentional non-adherence.

4. When you travel or leave home, do you sometimes forget to bring along your medication(s)?
Similar to the first question, this pertains to unintentional non-adherence. The act of forgetting to bring medication(s) when traveling or leaving home may stem from disruptions to daily routines or a lack of preparedness. It highlights the importance of developing strategies to ensure medication availability during such situations.

5. Did you take your medication(s) yesterday?
This question pertains to intentional non-adherence and is a straightforward inquiry about adherence on a specific day, enabling patients to recall their medication intake. It can help identify patterns and provide insight into individual adherence behaviors.

6. When you feel like your health condition is under control, do you sometimes stop taking your medication(s)?
This question probes unintentional non-adherence. Patients may believe that their health condition no longer requires ongoing treatment when they perceive improvements or symptom relief. Such perceptions can lead to a discontinuation of medication(s) without medical advice, potentially jeopardizing treatment outcomes.

7. Taking medication(s) every day is a real inconvenience for some people. Do you ever feel hassled about sticking to your treatment plan?
This question addresses intentional non-adherence related to the perceived inconvenience of medication regimens. Patients may experience difficulties incorporating medication(s) into their daily routines, resulting in intentional non-adherence due to perceived hassle or inconvenience.

8. How often do you have difficulty remembering to take all your medication(s)?
This question delves into unintentional non-adherence. Patients may experience challenges in remembering to take all their prescribed medication(s) as directed. Memory lapses or complicated medication schedules can contribute to unintentional non-adherence.

The Morisky 8-Item scale provide a valuable framework for understanding and differentiating between intentional and unintentional medication non-adherence. By addressing various aspects of adherence, these questions allow patients and healthcare providers to identify specific areas of concern and develop targeted interventions to improve medication adherence. Recognizing the underlying reasons for non-adherence is crucial in fostering patient education, promoting open communication, and tailoring educational counseling with the five domains of medication adherence enhances treatment outcomes and overall patient well-being.