Ethical Issues With Non-compliant Patients ::

Every pharmacist at some time has to deal with patients who, for one reason or another, fail to adhere to their medication guidelines.

There are different reasons for this. Patients may stop taking medication because they don’t like the side effects. They may not have all of the information they need in order to know the consequences of their noncompliance.

In cases like these, the pharmacist has an ethical duty to provide help and guidance. The pharmacist needs to provide information to the patient about the nature of their condition, making sure the patient understands how it can affect their health. The pharmacist needs to talk to the patient about the medication, what its purpose is, why the patient needs to take it, and what the consequences are if the patient does not take it.

The idea, in keeping with the Code of Ethics, is not to coerce the patient, but in respecting the patient’s autonomy, to ensure the patient fully understands the situation.

In cases of noncompliance, it is important to establish the cause. It may be the pharmacist who filled the prescription initially did not establish a good rapport with the patient, and as a result, the patient did not have all the information they needed. This is an ethical lapse on the part of the healthcare provider.

For example, a patient with late-onset type 2 diabetes is not taking his metformin. He has never been consistent about taking his medication because he does not like the side effects. He complains the metformin makes him go the bathroom too often.

In such a situation, there are two courses of action that a pharmacist can take. One is to sit down with the person and question him to determine the extent of his knowledge about his condition and the medication. And then, patiently explain to him what the medication does and why he needs to take it.

The second course of action is to find another suitable medication for his condition that does not have the side effects that annoy the patient. However, all drugs have side effects, and because this was the initial reason for the noncompliance, it is likely that the patient may also not take the new drug as he should.

So, the pharmacist still needs to counsel the patient thoroughly about his condition, the new drug and the importance of maintaining compliance.

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