%0 Journal Article
%T One Adherence Intervention Cannot Address Every Form of Nonadherence: Matching Initiation, Implementation, Persistence, Treatment Burden, and Patient Capability to Pharmacy Practice Interventions
%A Youssef Hariri
%A Hassan Nasser
%A Fatima Zahra
%J Annals of Pharmacy Practice and Pharmacotherapy
%@ 3062-4436
%D 2026
%V 6
%N 1
%R 10.51847/KsWtzz9iiV
%P 82-92
%X Medication nonadherence is commonly managed as if one problem could be corrected by one broadly applicable adherence intervention. This paper develops a methodological approach for matching pharmacy-practice interventions to the medication-taking process that has failed, while separately considering treatment burden, patient capability, access constraints, and implementation feasibility. An evidence-bounded conceptual development process was used. Established distinctions among initiation, implementation, and persistence were combined with evidence on adherence measurement, patient-reported assessment, intervention content, treatment burden, medication-management capacity, affordability, and implementation. Evidence-supported distinctions were separated from new synthesis. The resulting method was constructed as a proposed decision approach rather than a validated clinical algorithm. The analysis indicates that an identical observed adherence deficit may arise from different temporal processes and mechanisms. A patient who never initiates treatment, a patient who intermittently implements a regimen, and a patient who discontinues treatment require different diagnostic questions before intervention selection. Treatment burden and patient capability further modify whether an otherwise plausible intervention is feasible. The proposed method therefore sequences phase identification, barrier assessment, burden–capability appraisal, intervention-mechanism selection, and reassessment. It also identifies predictable mismatch conditions, including access barriers treated with reminders, adverse-effect-related discontinuation treated as forgetfulness, and digitally delivered support that adds workload. Pharmacy adherence support should be conceptualized as a matching problem rather than intervention escalation. The approach remains unvalidated, context dependent, and subject to measurement uncertainty; prospective and pragmatic testing is required before claims of clinical effectiveness or implementation readiness.
%U https://galaxypub.co/article/one-adherence-intervention-cannot-address-every-form-of-nonadherence-matching-initiation-implement-50yfpfdozai72wp