Screening Tools used
Step 1: Administer the MMAS-4 to Screen for Adherence 1. Introduce the MMAS-4: Explain to the patient that you will ask a few questions to assess how well they are following their prescribed medication regimen. Emphasize that there are no right or wrong answers. 2. Ask the MMAS-4 Questions: 1. Do you ever forget to take your medication? 2. Do you ever have problems remembering to take your medication? 3. When you feel better, do you sometimes stop taking your medication? 4. Sometimes if you feel worse when you take your medication, do you stop taking it? 3. Score the MMAS-4: • 4 = High adherence • 2-3= Medium adherence • 0-1 = Low adherence 4. Interpret the Results: • High adherence (4): No further action is needed. • Medium adherence (2-3): Use clinical judgment to decide if further screening is necessary. • Low adherence (0-1): Administer the MMAS-8 for a more in-depth assessment. Step 2: Administer the MMAS-8 for Low Adherence Patients 1. Explain the Purpose: If the patient scores low on the MMAS-4, let them know that you will ask a few more detailed questions to understand their medication-taking behavior better. 2. Ask the MMAS-8 Questions: 1. Do you sometimes forget to take your medication? 2. People sometimes forget to take their medications for reasons other than forgetting. Thinking over the past two weeks, were there any days when you did not take your medication? 3. Have you ever cut back or stopped taking your medication without telling your doctor, because you felt worse when you took it? 4. When you travel or leave home, do you sometimes forget to bring your medication? 5. Did you take your medication the last time you were supposed to take it? 6. When you feel like your symptoms are under control, do you sometimes stop taking your medication? 7. Taking medication every day is a real inconvenience for some people. Do you ever feel hassled about sticking to your treatment plan? 8. How often do you have difficulty remembering to take all your medications? 3. Score the MMAS-8: • High adherence: Score of 8 • Medium adherence: Score of 6-<8 • Low adherence: Score of <6 Identify Intentional vs. Unintentional Non-Adherence Step 3: Identify WHO Dimensions of Adherence WHO outlines 5 key dimensions that influence medication adherence: 1. Social/Economic Factors:
Step 4: Develop a Medication Adherence Action Plan (MAAP) 1. Morisky Score
By utilizing the MMAS-4 and MMAS-8 effectively and considering the WHO dimensions of adherence, pharmacists can create a patient-centered plan to significantly improve medication adherence.
0 Comments
Leave a Reply. |
AuthorDr Donald Morisky. Archives
October 2024
Categories |