Medication Adherence: Practical Strategies for Building a Consistent Medication Routine

Written By Z. Hamilton Avery

many people, this is not as simple as “just remembering.” Medication routines can be affected by cost, side effects, confusion, depression, anxiety, stigma, transportation, pharmacy access, refill problems, schedule changes, forgetfulness, health beliefs, or not feeling sure the medication is helping. When medication is part of a treatment plan, adherence is not about being “good” or “bad.” It is about building a realistic system that helps the medication have the best chance of working.

Support begins with curiosity instead of shame. If taking medication has been difficult, the most helpful question is usually not “Why did I not just take it?” A better question is, “What got in the way and what support would make this easier next time?” Research suggests that adherence improves most when interventions are practical, individualized, and matched to the person’s real barriers. Helpful strategies may include education, reminders, simplified routines, problem solving, follow-up, Motivational Interviewing, refill support, and conversations about side effects, access, beliefs, and confidence.

A helpful next step is to identify the main barrier. If the issue is forgetfulness, try pairing medication with an existing routine, such as brushing your teeth, eating breakfast, feeding a pet, or preparing for bed. If the issue is organization, consider a pill organizer, medication list, reminder alarm, or visual cue near something you already use daily. If the issue is refills, ask about automatic refills, delivery, a 90-day supply, or setting a reminder one week before running out. If the issue is cost, ask the prescriber or pharmacist about generics, savings programs, insurance alternatives, or lower-cost options. If the issue is side effects, uncertainty, or fear, write down the concern and talk with the prescriber before making changes on your own.

It may also be worthwhile to explore motivation and ambivalence. Some people want the benefits of medication but feel frustrated by needing it. Some worry about dependence, identity, stigma, side effects, or whether the medication is really necessary. These concerns deserve respect and discussion. A helpful reflection might be: “Part of me does not want to take this and part of me wants to feel better, stay stable, reduce symptoms, or protect my health.” Medication adherence becomes more sustainable when the plan connects to your own reasons, such as feeling more stable, sleeping better, reducing symptoms, managing pain, preventing relapse, staying out of the hospital, being present with family, or supporting long-term goals.

Important Reminder

Never stop, restart, increase, decrease, skip, double up, or mix medications without talking with a qualified prescriber or pharmacist unless you have been specifically instructed to do so.

References

Conn, V. S., Ruppar, T. M., Enriquez, M., & Cooper, P. (2016). Medication adherence interventions that target subjects with adherence problems: Systematic review and meta-analysis. Research in Social and Administrative Pharmacy, 12(2), 218-246. https://doi.org/10.1016/j.sapharm.2015.06.001 ⁠

Nieuwlaat, R., Wilczynski, N., Navarro, T., Hobson, N., Jeffery, R., Keepanasseril, A., Agoritsas, T., Mistry, N., Iorio, A., Jack, S., Sivaramalingam, B., Iserman, E., Mustafa, R. A., Jedraszewski, D., Cotoi, C., & Haynes, R. B. (2014). Interventions for enhancing medication adherence. Cochrane Database of Systematic Reviews, 2014(11). https://doi.org/10.1002/14651858.CD000011.pub4 ⁠

Ruppar, T. M., Cooper, P. S., Mehr, D. R., Delgado, J. M., & Dunbar-Jacob, J. M. (2016). Medication adherence interventions improve heart failure mortality and readmission rates: Systematic review and meta-analysis of controlled trials. Journal of the American Heart Association, 5(6). https://doi.org/10.1161/JAHA.115.002606 ⁠

Torres-Robles, A., Wiecek, E., Tonin, F. S., Benrimoj, S. I., Fernandez-Llimos, F., Garcia-Cardenas, V., & Perez-Escamilla, B. (2018). Comparison of interventions to improve long-term medication adherence across different clinical conditions: A systematic review with network meta-analysis. Frontiers in Pharmacology, 9, 1454. https://doi.org/10.3389/fphar.2018.01454 ⁠

Zomahoun, H. T. V., Guénette, L., Grégoire, J.-P., Lauzier, S., Lawani, A. M., Ferdynus, C., Huiart, L., & Moisan, J. (2017). Effectiveness of motivational interviewing interventions on medication adherence in adults with chronic diseases: A systematic review and meta-analysis. International Journal of Epidemiology, 46(2), 589-602. https://doi.org/10.1093/ije/dyw273

Z. Hamilton Avery

Z. Hamilton Avery, LCSW, BC-TMH, CMT, CYT-1,000, TIYT (he/they) is a queer and non-binary therapist, health educator, wellness coach, body and energy worker, yoga and meditation teacher, and abstract artist in Tulsa, Oklahoma. In addition to having obtained over a dozen certifications in various modalities of complementary and alternative medicine (CAM), Z holds an associate’s degree in pre-nursing studies, a bachelor’s degree in psychology, and a master’s degree in social work. When supporting clients and students, Z takes a humanistic, person-centered, strengths-based, trauma-informed approach. Their practice is grounded in compassion, harm reduction, inclusivity, social justice, and evidence-based interventions. Ultimately, Z’s mission is to provide a safe and non-judgmental space for adolescents (13+) and adults who are navigating challenges such as anxiety, depression, trauma, addiction, pain, and chronic illness; he does this by offering sessions, classes, groups, workshops, retreats, and trainings.

Understanding that mental health is interconnected with many other facets of life, Z takes a holistic approach to therapy. Knowing that there is no one-size-fits-all treatment, he strives to honor the uniqueness of each client by custom-tailoring his approach to best meet the needs, preferences, and goals of each individual. For this reason, Z believes that it is imperative to be cross-trained in many different treatment approaches. As a therapist, they utilize a variety of evidence-based practices, including motivational interviewing (MI), cognitive behavioral therapy (CBT), acceptance and commitment therapy (ACT), dialectical behavior therapy (DBT), eye movement desensitization and reprocessing (EMDR), and written exposure therapy (WET). As a body and energy worker, Z is certified to practice massage therapy, Thai yoga massage, myofascial release, craniosacral therapy, and reiki. They are also certified in both Chinese and Japanese styles of acupuncture. After completing more than 1,000 hours of accredited yoga teacher training (primarily in India), Z is certified to teach various styles of yoga, including Hatha, Kundalini, yin, and restorative. He also researches and writes about topics including stress, trauma, self-care, mindfulness, self-compassion, holistic health and well-being, CAM, HIV/AIDS, and issues related to the Two-Spirit, lesbian, gay, bisexual, transgender, queer, intersex, agender, plus (2SLGBTQIA+) community.

https://www.therapywithz.com
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