Adherence to medicines is defined as the process by which people use their medications as prescribed. Inversely, non-adherence is defined as any deviation from the therapy plan, either at the beginning, during its implementation or duration. Non-adherence may limit the benefits of medicines, resulting in lack of improvement (or deterioration) in health, and may represent a loss to the patients, healthcare system and society. Causes of non-adherence are manifold but they fall into two overlapping categories: intentional (that is, when the patient decides not to use the medication or to use it in a way that differs from the recommendations) and unintentional (that is, when the patient is prevented from using the medication by factors beyond his control e.g. forgetfulness or language barriers).

Community pharmacists are permanently in contact with patients and often serve as the first contact point for patients who have questions regarding their therapy. Therefore, community pharmacies play a paramount role in patient care that can be further strengthened by providing professional pharmacy services.

During their daily routine, pharmacy teams address systematically non-adherence and explore patients' perspectives of medicines and why patients may not want or be able to use them. Thus, we see pharmacy teams screening patients with medicines use problems, and offering targeted interventions. Patients with chronic medicines use and modifiable determinants of non-adherence will be at target. For this, we have developed a two-steps adherence consultation. The 15-STARS questionnaire (Arnet I et al. Res Social Adm Pharm 2024 Mar; 20(3):308-32) and electronic monitoring will be part of the assessment instruments. The goal will be to offer an intervention tailored to patients’ needs, and maintaining the pharmaceutical competences in the relationship patient-pharmacist. Rich of successful results from various studies, we will launch this new pharmacy-based service in 2025.

App-based Adherence Service in Primary Care

We have developed two adherence studies that propose a Swiss smartphone application (mednet patient^TM and TOM^TM-app) to ambulatory patients who can track medication intake and symptom course. The two app-based adherence services target patients with a short-term antibiotic therapy (SMAPP-Study - smartphone app assisted antibiotic therapy) or with a 30 days PPI therapy (PIPPI-Study - potentially inappropriate prescription of PPI). We are now testing the feasibility and effectiveness of both studies in Swiss community pharmacies.

We are now recruiting additional pharmacy teams for both studies. Please consider that the SMAPP study will terminate by the end of 2024 and that 100 FPH-points can be earned by  participants. For further information, please contact kirstin.messner@clutterunibas.ch or visit the following link: Project Flyer

Patient preferences for vitamin D3 oral intake (Dr Jean-Pierre Rothen since JAN 2017)
A usual diet and normal exposition to sun light in temperate latitudes render vitamin D supplementation indispensable in the wintertime. Beside various frequencies (daily, weekly, monthly) of recommended equivalent cumulative doses, pharmaceutical formulation (solid, liquid) can influence adherence. In this project, we investigated preferences for intermittent administration (weekly vs monthly) and formulation (solid vs liquid) in 106 outpatients with vitamin D deficiency, under electronic monitoring of all intakes [EKNZ-Nr. 2017–00300; doi: 10.1186/s40360-020-00430-5]. In a following study, we are evaluating the benefits of an individualised vitamin D3 loading regimen on achieving optimal vitamin D serum values [EKNZ-Nr. 2019-00749; ClinicalTrials.gov ID: NCT03920150].