Narrative Medicine: Does Pharmacist-Patient Communication Improve Medication Adherence?

Abstract

In Western countries, medication adherence reaches only about 50% among patients affected by chronic diseases who require complex and long-term therapies. The lack of adherence causes suboptimal clinical results and increases National Healthcare System (NHS) spending. Considering the progressive aging of the general population, the increase in chronic diseases and the decrease in resources, enhancement of adherence will improve the allocation of resources as well as patients' quality of life. An overview of the literature suggests that improving therapy adherence may improve results more effectively than other therapeutic interventions. The research project described in this report focused on the communication between patient and pharmacist and aimed to evaluate the feedback on therapy adherence in hemodialysis patients. Narrative medicine and multivariate statistical analysis were employed and compared. Structured interviews were conducted with hemodialysis patients treated at the Nephrology and Dialysis Unit of the San Francesco Hospital in Nuoro, Sardinia. The results suggested that the alliance with the pharmacist could be greatly improved in relevant aspects, including paying more attention to the patient's psychophysical conditions. Pharmacological counseling may thus allow to improve therapy adherence. The narrative interview revealed the need of patients to communicate more and to form an alliance with the pharmacist that is crucial to enhancing adherence. This experience may support the practical use of narrative medicine in identifying patients' needs and suggesting corrections to current practice.