Medication adherence plays a critical role in managing chronic conditions and achieving optimal health outcomes. However, non-adherence is a widespread problem: 1 in 5 new prescriptions in the United States are never filled, and of those that are, 50% are taken incorrectly.[1]
Medication non-adherence is associated with substantial worsening of disease, higher mortality rates, and increased healthcare costs[2]. According to the U.S. Centers for Disease Control and prevention, more than $100 billion of U.S. healthcare dollars spent each year have a direct attribution to medication non-adherence and resulting trips to the emergency room[3].
Types of Medication Non-Adherence
Part of the challenge when addressing medication non-adherence is the variety of reasons that could lead a patient to not complying with their prescribed regimen. There are four key types of non-adherence when it comes to medication management:
Non-Fulfilment Adherence is one of the most common types of non-adherence, in which providers write a prescription for a patient, but the medication is never filled. A primary driver of non-fulfilment is lack of access, as there are many patients across the United States who cannot afford to pay for their medication or cannot physically get to the pharmacy to pick up their prescriptions.
Non-Persistence Adherenceis when a patient makes the active decision to stop taking a medication after starting it. This often occurs when a patient is not seeing a reduction in symptoms as quickly as desired, or if a patient is experiencing side effects that they deem to be not worth it.
Non-Conforming Adherenceis when a patient does not take their medication as it was prescribed. Examples of this may include self-adjusting dosage or improper timing of dosing. Patients who do not take medication as prescribed, especially in instances of polypharmacy, are at risk of unintended drug interactions, increased severity of side effects, and failure of treatment.
Unintentional Non-Adherenceis when a patient does not take their medication properly as a result of unplanned or unintentional behavior. If you find yourself forgetting to your medication with you when you travel or struggle to recall which medications should be taken together, you might be unintentionally non-adherent with your prescriptions[4].
Solutions for Improving Adherence
MedMinder was recently featured in Forbes Business to answer the question: What can healthcare leaders do about non-adherence?
Redefine How We Track Adherence
There has historically never been a good way for the industry to track adherence beyond filling a prescription. Providers can best support patients if they can ensure they are physically taking their medications. With advances in technology and telehealth, providers can be more present, offer more periodic check-ins, and help patients build a strong care team from afar.
Increase Access to Medication
Cost, transportation, [and] language barriers should not and cannot stop people from filling and taking medicine as directed by a healthcare provider. According to a recent survey byiPrescribe, more than a third of patients are not taking their medication as prescribed due to the high cost involved.[5] Healthcare providers should have conversations with their patients about where they get their medications, and when possible, find them cheaper alternatives.
Empower Healthcare Providers
We need to empower our healthcare providers, especially case managers, with resources such as tracking technology, so they can spend their valuable time with the actual patient – not in the bathroom or kitchen sorting and counting pills. We should also empower case managers to better manage their patient’s treatment plans by communicating more directly with pharmacists and doctors.
By enhancing a patient’s ability to stay adherent, we can make progress in our efforts to improve health outcomes, reduce hospital stays, and avoid unnecessary spending.
[1] https://www.cdc.gov/mmwr/volumes/66/wr/mm6645a2.htm
[2] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3191684/
[3] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3934668/
[4] https://www.nejm.org/doi/full/10.1056/nejmra050100#
[5] https://www.iprescribe.com/insights/americans-not-taking-medication
