Preventing medication nonadherence: a framework for interventions to support early engagement with treatment 2024 , Chapman, Chalder et al

ABSTRACT
Medication nonadherence is common and results in avoidable morbidity, mortality, and burdens on healthcare systems. This paper proposes a preventative approach to medication nonadherence. We consider existing evidence on the prevalence and determinants of nonadherence early in a patient’s medication-taking journey, and map these to potential opportunities for intervention. Many patients stop taking a new medication soon after they are prescribed it, often not collecting the medication. Early patterns of nonadherence are linked to later nonadherence via processes such as habit formation and symptom experiences. Known predictors of nonadherence may be present before someone starts a new treatment, when patients experience disruption to their lives and identity due to illness. Healthcare professionals typically have contact with patients around this time.

We argue that it may be possible to prevent medication nonadherence: at the population level; by optimising the prescription process; and through low- and high-intensity interventions for patients with identified early barriers. We give examples of specific interventions and tools that might be needed to operationalise this approach in practice and propose new directions for research to promote early engagement with medication to prevent nonadherence.

https://www.tandfonline.com/doi/full/10.1080/17437199.2024.2385525#abstract

 

I would think there are several more obvious things to try before yet another form of CBT.
Spend more than a couple of minutes talking to patient before prescribing. Possibly even do some tests??
Check patient previous history for risk of any adverse reactions.
Warn patients of possible side effects.
Review medication much sooner after patients start.
Listen to any patient concerns, don't just refer them somewhere, particularly when it can take months to get a referral appointment.

and it would also help us if the medical profession actually considered that we are already sick with ME, therefore many symptoms might be ME related or exacerbated by having ME. And likewise drug intolerance is common.

 

For many people the cost of a prescription puts them off.
Also those living on very low incomes may not have the money to buy a 3 or 12 month prepayment certificate (PPC).
These save money if you need regular prescriptions:
"There are 2 PPC options: a 3-month PPC costs £32.05 and will save you money if you need more than 3 prescribed items in 3 months. a 12-month PPC costs £114.50 and will save you money if you need more than 11 prescribed items in a year."

 

I would say side effects of many drugs are just not acceptable to many patients the one size fits all approach of modern medicine is an obvious false economy that does untold harm to many patients .