Fixing a Hole: Using TDM to Address Medication Non-Adherence

Adherence to medication is the very basic level we wish to reach in patient care. Yet for many patients taking drugs every day (sometimes several times a day, over long periods of time, this is far from straightforward. Treatment failure and adverse drug reactions can result not from the wrong medicine, but simply from inconsistent intake. Non-adherence is rarely intentional; it is a complex, multifaceted problem shaped by practical barriers, patient perceptions, and the realities of daily life. Therapeutic drug monitoring offers a powerful objective tool for fixing this hole — identifying who is and isn't taking their medication, enabling clinicians to have targeted, constructive conversations and intervene in ways that can make an effective difference.

In this episode we'll hear about:

• What adherence really means, and why it matters clinically and for society

• The importance of objective measures and the role of drug measurement

• What patients really think about the 'vigilance' associated with adherence monitoring and having constructive conversations

• Innovations on the horizon for adherence monitoring, including dried blood spot sampling, point-of-care testing, and what these tools could mean for primary care and resource-limited settings

About our guests:

Jorie Versmissen is an internist and clinical pharmacologist at Erasmus Medical Centre in Rotterdam, the Netherlands, with a research interest in adherence to antihypertensive medication. Jorie is also a familiar voice to regular listeners as our recent co-host, today joining us on the other side of the microphone.

Lene Halvorsen is a nephrologist at Oslo University Hospital, Ullevål, in Norway. She also has a special interest in hypertension, both in the clinic and in research, and is an elected council member in the European Society of Hypertension. Lene recently completed her PhD on the topic of adherence to antihypertensive medication, where Jorie was one of her opponents.

Eight Drugs a Week is supported by the International Association of Therapeutic Drug Monitoring and Clinical Toxicology (IATDMCT). The personal views of the hosts and guests do not necessarily reflect the position of the Association.