Medication plays a vital role in chronic disease management.
The World Health Organization (WHO) defines adherence as “the extent to which a person’s behavior – taking medication, following a diet, and or executing lifestyle changes – corresponds with the agreed recommendations from a provider.”
Proper adherence to a medication schedule is always associated with improved health outcomes, especially in chronic disease management. Conversely, improper medication adherence is typically associated with a decreased quality of life, increased ER visits, hospitalizations, and readmissions, leading to an increased burden on the patient’s health, as well as the healthcare system.
For many Americans, taking their medications according to their provider’s instructions is a huge challenge. According to studies, poor medication adherence has led to an increase in death rates of about 125,000 people, and the expenditure of approximately $100-$300 billion of U.S. healthcare dollars annually. Nearly 3 out of 5 American adults consume at least one daily medication. However, around 80% of chronically ill patients have dropped out of their chronic care management plans, including medication regimens. In the United States alone, an estimated 3.8 billion prescriptions are written annually. But about 1 in 5 of these new prescriptions are not filled. Among the filled ones, around 50% are consumed improperly with regards to dosage, duration, and frequency. With that said, improvements to medication adherence are needed to help alleviate the economic burden on the healthcare system.
This article highlights the challenges and contributing factors of the current healthcare crisis and explore a few ways to improve adherence towards medications.
What Could Be the Barriers That Influence Medication Adherence?
It’s not enough to simply tell patients to consume their medications. This has been common practice for centuries but doing this alone will not solve the issue. Instead, doctors should be using their communication skills to learn about why their patients are not consuming their medication according to their prescriptions.
There are several barriers to proper medication adherence. Unintentional barriers include simply forgetting to take medications or refill prescriptions, as well as an overall inadequate understanding of medication doses. On the other hand, intentional barriers include the cost of medication and the side-effects, which often leads to a patient deciding to stop or modify their medication regimen due to their own perceptions about the drug.
Regardless of the barriers, providers can help improve medication adherence by uncovering these roadblocks and developing more in-depth patient-centered strategies.
How Can We Develop a Patient-Centered Approach to Increase Adherence?
There are three distinct processes related to medication adherence.
1. Initiation
In this phase, the patient might skip the initiation of medication consumption due to forgetfulness. After all, they might not have had any time to get used to their new medication schedule. The solution to this simple issue is that the patient must be educated on the significance of their medication, how they can properly administer it, and proper warning should also be given about the potential side effects if the medication is skipped.
Many patients face their own mental barriers or fears of stigma, which keeps them from taking their pills. Mental barriers are almost just as prevalent as external barriers, such as cost or side effects. Providers should work to help their patients overcome mental barriers and the stigma associated with taking prescription medication, by motivating them and coaching them on taking their prescribed medication properly.
2. Implementation
In this second phase, the patient might struggle to remember their medication schedule, which could lead to delayed doses or taking an extra dose by accident. Solutions to this include writing the schedule on a calendar, creating phone reminders, and the use of pillboxes. Since medication management poses a significant threat to all chronically ill patients, several chronic care self-management apps have been designed to send reminders to patients to take their daily medications.
However, this strategy isn’t always effective, especially for elders and patients below the poverty line due to late technology adoption, lower literacy, and not to mention, the mere hopelessness with their conditions. A strategy like using a pillbox is often the best choice and can significantly improve medication adherence, holding patients accountable for their own dosages. This is because, when the patient opens the pillbox, the provider receives the necessary information to detect medication adherence.
3. Discontinuation
Lastly, patients often stop taking their medicines, either with or without the provider’s guidance due to increased drug costs. Solutions for this involve timely medication refills, as well as explaining the importance of long-term medication use to your patients, especially when the condition is asymptomatic.
High drug costs are afflicting the entire healthcare industry. A recent report by Consumer Reports Best Buy Drugs showed that 25% of patients are paying more for their medications than ever before, and 14% can’t afford to fill prescriptions due to high costs. However, medication subsidies can also help improve medication adherence.
A 2017 study showed that patients who received Medicare Part D subsidies were more likely to take their medications than those without the subsidies. 69% of African-American patients, 70% of Hispanic patients, and 61% of Caucasian patients receiving the subsidy achieved full medication adherence by study’s end. These results were likely because subsidized medications are significantly cheaper, coming in at around $10. Whereas those without the subsidies faced costs of more than $100 per medication. Therefore, medication subsidies are a huge win for a patient and the healthcare system.
Improving Medication Adherence
Of course, there is no universal solution to improve medication adherence. However, a customized toolbox can be created with a variety of solutions tailored specifically to each stage of medication adherence. This helps ensure medication adherence, as well as improved patient health.
For more information, speak with Hifinite’s team about the implementation of hiCare Comply. With hiCare Comply, you will realize a significant improvement in medication adherence among your patients.