In psychiatric contexts, adherence is usually talked about as a choice made by the patient. Much of it is really a routine problem: the dose that you need in the morning that you didn't have, the script that you were supposed to pick up on a day you couldn't get out, the pack that ran out on a bad fortnight.
Support workers sit exactly where those failures happen and have a much narrower range of what they can do about them than most realise.
Prompt and remind. Assist with a pharmacist-prepared dose administration aid. Remind and document missed doses of medication. Support the practical chain: the script, the pharmacy, the dose routine.
Administering medication where they are not trained and authorised. Making any PRN judgement. Modifying or giving an alternative dose. Determining if presentation changes are drug effects. Rules vary by state, setting and individual arrangement, so the safest approach is to enquire what a particular worker is trained and authorised to do, rather than assuming.
Routine before reminders. If a worker comes in at the same time, it becomes the morning the dose happens.
An agreed-in-advance pathway for a refusal or a missed dose, no improvising.
Recording that is fast and factual, a pattern of missed doses becomes obvious, not anecdotal.
Refusal is information to record and escalate, not non-compliance to manage. The worker records it and escalates it. Whether it matters is a clinical question.
Imagine a patient with poor adherence who has a consistent pattern of missed mornings and taken evenings on their Webster pack. The mornings resolve once morning support is in place. Nothing about his medication changed.
Before reading non-adherence as intent, ask what the patient's mornings are like.
Connect Your Patient With Consistent Support. In Support Network, training is shown on worker profiles, and medication roles are never assumed from training alone.