The Importance of Patient Adherence to Medication Therapy

As former Surgeon General Dr. C. Everett Koop said, “Drugs don’t work in patients who don’t take them.” Prescription medications are only effective when they are taken. 

In many pharmacy circles, the term medication “adherence” and medication “compliance” are used virtually interchangeably.  However, in more recent years, the pharmacy profession and pharmaceutical industry have gravitated more toward medication adherence as the term of choice.  Adherence to a medication regimen is usually defined as the extent to which patients take medications as prescribed by their healthcare providers.

Non-adherence is a serious problem in the United States, causing thousands of premature deaths and demanding care that would otherwise have been unnecessary. According to the Journal of Managed Care Pharmacy, every day, 342 people die because of poor medication adherence.  That’s 125,000 Americans who die unnecessarily each year because of not taking their medications as directed by their physician and pharmacist.

In terms of economic impact of poor medication adherence, the New England Healthcare Institute estimates that the annual cost of patients not taking their medications as prescribed approaches $290 billion.

But, unfortunately, there is no single magic bullet for poor medication adherence.

Mirixa, a company dedicated to improved patient outcomes with prescription drug therapy has determined that patient non-adherence is best addressed through comprehensive medication therapy management services (MTM).  The most effective MTM programs achieve the highest return when those services are delivered by a pharmacist (as opposed to a general healthcare professional or a call center employee). 

But, education also is a key and essential part of successful patient adherence programs.  Physicians must directly engage patients to discuss the importance of prescription drug therapy. Then, pharmacists need to help patients understand their important role as a partner in their healthcare.

However, education alone rarely works. A fully integrated approach with support resources and innovative tools appears to be the best approach.

Creating a culture which embraces patient adherence can be a win-win-win situation.  With a good patient adherence program, the patient has better outcomes when taking their medications correctly. When incentives are properly aligned, the prescribing physician has a patient who is being well treated and responding to his or her prescription drug therapy. And, the health plan doesn’t have to pay for unnecessary hospital admissions.

Innovative medication packaging can also help improve patient compliance.  MWV is a national leader in patient adherence and compliance-enhancing packaging. By developing patient-centered packaging solutions that help pharmacies improve patient medication adherence, MWV has also been able to minimize medication errors and reduce the overall cost of health care. According to a new study published in the May 2011 issue of Clinical Therapeutics, the manner in which a medication is packaged can have a significant impact on whether patients take it as prescribed. The study showed that compliance-enhancing packaging was associated with an improvement in prescription adherence behavior in patients when compared with traditional pill vials. To see more about compliance-enhancing packaging, visit http://www.meadwestvaco.com/HealthcarePackagingSolutions/MWV031086.

Medication adherence is a serious problem which needs to be addressed. At the Center for Health Transformation (CHT), we are collecting best practices and innovative strategies to help patients, pharmacists, physicians, and health plans improve patient compliance. Later this year, we will be publishing a second publication dedicated to advancing those strategies, programs and best practices which help improve patient adherence while reducing healthcare costs.

4 comments Add your comment

Long Beau

August 3rd, 2011
11:15 am

Mr Oliver is just pimping his clients. This should be in the advertising section. Or in the children’s section… “Prescription medications are only effective when they are taken.” Seriously?? Duh.

MrLiberty

August 4th, 2011
12:29 pm

That’s 125,000 Americans who die unnecessarily each year because of not taking their medications as directed by their physician and pharmacist.

And another 45,000 die BECAUSE they took what they doctor prescribed.

Sounds like the best approach is a naturopathic/homeopathic approach. But of course folks like you lobby the FDA every day to make sure that these highly effective alternatives are driven out of the marketplace and their purveyors locked up. Just another of the failings of current western medicine and the corrupt industry-FDA relationship.

Wayne Oliver - vice president, Center for Health Transformation

August 4th, 2011
12:49 pm

Thanks Long Beau for your comment. The problems associated with medication non-compliance cost needless lives and billions of dollars. In the post, I tried to highlight real-world solutions that are working. Mirixa and MWV are doing great work at saving lives and saving money. In my opinion, highlighting programs where patients have better health outcomes at lower costs is not “pimping.”

Wayne Oliver - vice president, Center for Health Transformation

August 4th, 2011
12:57 pm

MrFreedom, thanks for your comment. I largely agree with your comment. Often, a holistic approach to healthcare is appropriate. However, when medical interventions are necessary and a physician (or other prescriber) prescribes one or more prescription medications, patients should know why that therapy was selected, how to properly take the medication and understand the consequences of not taking the prescribed therapy.Patients, physicians and pharmacists must work together to advance the health, welfare and safety of the patient. In short, we need a major cultural shift.

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