Strategies for Improving Medication Adherence

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May 31st, 2013
Categories: Healthcare Reform

medication adherencePrescription medications are essential in preventing and managing chronic conditions. However, two out of three Americans do not take medications as prescribed.  Poor adherence to prescribed medication leads to higher healthcare costs, unnecessary utilization and unnecessary suffering from illnesses like cancer, COPD, diabetes, heart disease, depression and hypertension.

Nine out of 10 patients who adhere to prescribed medication regimens describe their health as “good” or “excellent”; only 2/3rds of non-adherent patients can make the same claim.  Many reasons, ranging from social factors and financial limits, to behavioral factors account for high prescription non-adherence. Factors such as using several different medications or multiple doses per day, medications that need to be refilled frequently, and the high cost of medications seem to be most common in leading to non-adherence.

Unfortunately, failing to take medication as prescribed is commonplace. It is costly and imposes negative health effects. Statistically:

  • 75% of patients occasionally fail to take their medication as directed
  • 33% of prescriptions are never filled
  • 50-60% of the time, chronic condition patients do not take their medications
  • 33-69% of medication-related hospitalizations are tied to medication non-adherence
  • 125,000 of patient deaths each year are related to drug noncompliance
  • $290 billion per year is spent on care required because of medication noncompliance

Strategies to Improve Adherence

  1. Non-compliance Detection. Detecting non-adherence is the first area of tackling this statistic. Many patients are reluctant to share their barriers to adherence and prefer not to be approached about prescription adherence altogether. A recent poll revealed that 58% of non-adherent patients are more likely to stick to their medication regimen as prescribed if they had more information about the potential negative effects of foregoing the medication. Providers can start to prevent patient non-adherence by taking the initiative to reassure patients of common concerns, and offering information about the risks of skipping medications.
  2. Medical Technology. Most noncompliance stems from patients who deliberately decide to sacrifice medication, but medical technology can help those with forgetfulness or those who don’t understand medication instructions. Clearer labeling along with clever packaging that may perhaps, separate medication by consumption frequency can be a great deal of help.
  3. Out-of-Pocket Costs. A common medication concern, cost, cannot be ignored.  Out-of-pocket costs frequently discourage patients from filling prescriptions. Each $10 increase in co-payment is directly tied to a 10% increase in noncompliance. Studies suggest that patients with no co-payment are approximately 3-8% higher in compliance than those with a co-payment.
  4. Pharmacist Influence. Even after patients leave the provider who prescribed the medication, their pharmacist can be a resource to address concerns. Pharmacists can provide assistance by simplifying drug regimens, offering larger medication supplies, suggesting lower cost substitutions, answering questions about how medications work and following up with patients about any problems they may have with the medication.

Several coalitions are on the rise in attempt to reduce medication adherence problems.  For example, The Partnership to Fight Chronic Disease is a new coalition aimed to develop, promote and help enact policy solutions to improve medicine adherence nationwide. Another group, Prescriptions for a Healthy America is a partnership of patients, healthcare providers, pharmacy organizations, consumers and healthcare industry leaders with the goal to develop near-term policy solutions to improve medication adherence.


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