Although prescribers play an essential role in the choice of medicines, the role of the consumer is equally important. Public knowledge, attitudes, and perceptions regarding the use of medicines influence the decision whether to seek health care, from whom, and whether to follow the proposed treatment. In some countries, most medicines can be bought directly over the counter, often from unauthorized sources, often in response to aggressive commercial marketing, and often through illegal sales of prescription-only medicine.
For consumers to use medicines appropriately, they need to know how to take them, what to avoid, and what negative effects to watch for. Communication is needed at a general level to give people a better understanding of what medicines are, how they act in the body, what their risks and benefits are, and what their role is in health care. At a more specific level, interventions are needed to tackle particularly serious problems of misuse. Relevant strategies, based on known facilitating factors and possible constraints, must be developed and implemented.
An increased focus on treating chronic diseases in developing countries, including HIV/AIDS, has resulted in research designed to promote treatment adherence. A major concern regarding poor adherence to treatment for infectious disease is the development of antimicrobial resistance; poor adherence is also costly in terms of the patient’s quality of life, the subsequent increase in health care expenditure, and reduced productivity. Components to address in promoting adherence include -
- Communication between providers and patients
- Inadequate counseling
- Lack of resources for medicines and treatment
- Complexity and duration of treatment
- Availability of information
Strategies to encourage appropriate medicine use by the consumer can be public or patient centered, but they should always be culturally specific. A public-centered approach provides the community, or target populations within the community, with information on the role of medicines and on how to make appropriate health seeking decisions at times of illness.
Seven steps toward more effective communication strategies are -
- Describe medicine use and identify problems
- Prioritize problems
- Analyze problems and identify solutions
- Select and develop intervention
- Pretest intervention
- Implement intervention
- Monitor and evaluate intervention
Developing interventions in collaboration with the people whose medicine-use patterns have been targeted for change helps ensure that the cultural and social context in which beliefs and practices have developed is taken into account. A variety of approaches and resources improves the chance of the intervention’s success and expands its capacity and reach.