Why We Need to Improve Drug Adherence

Patients improperly taking their medication not only results in longer cure times, repeat doctor visits and more illnesses being spread, it’s also causing the health-care system to hemorrhage money.

According to The National Consumers League, non adherence costs the country more than $290 billion a year.

“Three out of four Americans don’t take their medication as prescribed while one-third doesn’t even pick up their medication,” says Rebecca Burkholder, vice president of Health Policy at the National Consumers League. What’s more, about one-third of hospital admissions are related to not taking medication as directed, she says.

Non-adherence results in long-term health problems, which are more acute with patients suffering from chronic illnesses like diabetes, asthma or a heart condition—the patients that tend to have more complex medicine regimes.

“The statistics are staggering,” says Pradeep K. VanGala, an internal medicine doctor at Orlando Internal Medicine. “Non-compliance to medication with patients that have chronic illness was shown to be about 50%.”

Patients stray from their treatment regimes for a variety of reasons, but according to Burkholder, forgetfulness is the top reason--especially among patients taking multiple pills a day.

Patients often alter or don’t follow treatments because of the side effects. “If the side effects become uncomfortable and it’s hard to live they stop taking it,” says Burkholder.

Cost and lack of education are also reasons people choose to be non-compliant. According to medical experts, if people don’t understand why they are taking the medication or can’t gauge the benefits, they are more apt to stop taking it, figuring they don’t need it or it’s not effective.

“Some patients feel uncomfortable,” says VanGala. “They are scared, they are already taking four medications and they don’t know what could potentially happen taking another one.”

Non-compliance is a well-documented problem, but fixing it doesn’t come easy. The market is saturated with products and technology offering text messages, emails, alarms and alerts to patients needing to take medicine.

To help reduce the cost of treatment, doctors and pharmacists can direct patients to generic versions of their prescription drugs, hand out coupons, provide samples or encourage patients to shop around for the best drug prices. If approved, patients can also split pills to double their supply.

To make patients more aware and proactive in their health care, Burkholder says patients should write down questions for the doctor or pharmacists, like: what does the drug do, when should I take it, what happens if I miss a dose and any side effects are there.

“It’s a combination of communication and technology,” says Burkholder. “It’s a huge problem and there’s not one single good reason why people don’t take their medication.” To try to drive awareness of the problem, the National Consumers League launched a campaign called Script Your Future to educate consumers, family, caregivers and health-care providers about the importance of taking medications as directed. The group launched an interactive consumer website at www.scriptyourfuture.org.

VanGala has been using technology called PatientPoint to get more patients to adhere to medication. PatientPoint is a tablet-like machine that’s placed in the physician’s office and coordinates with patients’ records. After they sign in, PatientPoint lists the user’s medications and asks about compliance. If the user is not taking the medication, PatientPoint asks why--if cost is the reason the system will automatically print out a manufacturer coupon for the medicine. If side effects are listed as the reason, the doctor will be notified to work out a difference medication or treatment plan.

“This way we are not only engaging the patient on medication adherence, but we are also looking at [why] there’s non-adherence and are trying to address the problem,” says VanG ala.