Understanding the reasons behind medication nonadherence and exploring potential solutions

Dear Editor, Nonadherence to medications is a widely recognized factor contributing to unfavorable clinical outcomes in various health ailments including cardiovascular diseases.[1-3] The patient-related factors that contribute to medication noncompliance encompass forgetfulness, polypharmacy, a perceived lack of benefits, older age with multiple comorbid conditions, and low health literacy.[4] In this context, we propose the adoption of unique color-coded strip packaging as a prospective solution to improve medication adherence. Here, we present the outcomes of our recent research endeavor, aiming to uncover the causes of medication nonadherence and investigate prospective remedies among patients hailing from both metropolitan and nonmetropolitan areas. In the overall study population, financial limitations (32.3%), forgetfulness (26.1%), and lack of patient counseling (22.3%) were identified as the major reasons for medication nonadherence. In metropolitan areas, the leading cause of medication nonadherence was forgetfulness, accounting for 29.7% of cases. This was followed by inadequate patient counseling at 24.3% and financial constraints at 21.6%. Whereas, in nonmetropolitan areas, the predominant cause of medication nonadherence was financial constraints (36.6%); forgetfulness ranked second at 24.7%, followed by insufficient patient counseling at 21.5%. These findings underscore the need for improved patient counseling and the implementation of strategies to enhance medication recall, ultimately leading to improved medication adherence. The rate of nonadherence to secondary prevention measures was notably higher among elderly or dependent respondents residing in nonmetropolitan cities, with a prevalence of 41.9% compared to 35.1% in metropolitan areas. Conversely, in metro cities, there was a higher proportion of uneducated individuals who showed nonadherence, accounting for 32.4% as opposed to 26.7% in nonmetro cities. For improving adherence, patient education was the most preferred solution by patients from metropolitan (58.1%) cities, while patient education (41.3%) and unique packing differentiation (40.0%) were the most preferred ways by patients from nonmetropolitan cities. Pill reminders were the least preferred way to improve medication nonadherence selected by <10% of patients across the study groups. Patients from both metro (96.4%) and nonmetro cities (98.4%) were in strong agreement for consideration of unique pack colors for adherence improvement. The majority of respondents from both groups (metro: 100% and nonmetro: 97.0%) expressed a strong preference for using distinct strip colors to improve adherence. In summary, the collective findings suggest that forgetfulness and a dearth of counseling played significant roles in nonadherence. To address these issues, patient education and the use of distinctively colored strips emerged as favored solutions. These results underscore the significance of employing distinct strip colors to improve medication management, benefiting both patients and their caregivers. Financial support and sponsorship This initiative was funded by USV Private Limited, India. Conflicts of interest Santosh Revankar is an employee of USV Private Limited, Mumbai, India. All other authors have no conflicts of interest to declare. Ethical approval Ethical Approval was not obtained for this survey. No identifiable information was collected. Authors' contributions All authors contributed in study design, analysis, interpretation, writing/review of the manuscript. All the authors have read and approved the final version of the manuscript.