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Developing a practical primary health care handbook for managing medication adherence

Chiaki MISHIMA

Medication non-adherence – defined as the failure to take medicines as prescribed – remains a significant challenge in primary health care (PHC). Its consequences are wide-ranging, including poorer clinical outcomes, avoidable healthcare utilisation, increased medication waste, and substantial economic and environmental burden. Despite the availability of high-level recommendations, PHC teams often lack practical, user-friendly tools that can support the systematic integration of adherence management into routine workflows.To develop a concise, practice-oriented handbook that provides clinicians and other PHC professionals with actionable steps to identify, address, and monitor medication non-adherence during routine care.This project follows a multi-phase development process informed by international collaboration. An interdisciplinary Advisory Board consisting of healthcare professionals, patient representatives, and delegates from representatives from key global professional communities including ESPACOMP was convened. The handbook structure was co-designed through iterative consultations, beginning with an initial needs assessment conducted in early 2026. Planned stages include outline development, expert review at the WONCA Europe 2026 conference, chapter drafting, targeted consultations, and final consensus approval in February 2027. The resulting content will synthesize evidence-based adherence interventions, behavioural frameworks, and feasible monitoring strategies suited to real-world PHC settings.Preliminary outputs indicate strong alignment between PHC needs and the proposed handbook. Key components include: shared decision-making and co-creation of medication plans; approaches to identifying and addressing adherence barriers; feasible adherence-enhancing interventions; practical monitoring options; and opportunities for interprofessional collaboration. The final product will be an online, freely accessible resource incorporating flowcharts, case examples, and implementation tips. Anticipated results include increased capacity of PHC teams to recognise non-adherence, improved integration of adherence support into daily practice, and reduced avoidable medication waste.Embedding adherence management into PHC workflows requires tools that are pragmatic, scalable, and tailored to the realities of frontline practice. International co-creation strengthens the handbook’s relevance and transferability across health systems.The handbook aims to provide PHC teams with clear, implementable guidance to improve adherence, enhance patient outcomes, and support more sustainable use of medicines. Its launch is planned for World Adherence Day 2027.