Signs and Strategies to Prevent Covert Nonadherence
| Signs of covert nonadherence | Suggested prevention strategies |
|---|---|
| Refusing to speak | Mouth check |
| Moving the tongue inside the mouth | Liquid medications or water “chasers” |
| Quickly turning away | Officer observation and intervention |
| Leaving directly for the restroom | Restroom restriction |
| Diverting to peers in line or nearby | Restrict contact with peers in or near pill line |
| Unwillingness to show hands | Prefill pills in cup to hand to patient |
| Unexpectedly low-serum medication level | If available, consider long-acting injectable or liquid forms of the medication |