According to the World Health Organization, only about 50% of patients who suffer from chronic conditions take their medications as prescribed. This should raise concerns for patients and providers alike, as medication non-adherence accounts for half of treatment failures and approximately $300 billion in avoidable healthcare costs.
Medication non-adherence, or a patient’s failure to take a medication as prescribed, can take many forms, including:
- Not filling prescriptions
- Not starting treatment
- Using more or less of a medication than a prescribed amount
- Stopping medication prematurely
- Taking old medications for new problems without discussing with doctor
- Taking someone else’s medications
There are a number of reasons why a patient may exhibit these behaviors. According to the New England Journal of Medicine, patients tend to stray from their medication regimen due to five major overarching factors: patient-related (e.g., lack of confidence in treatment), socioeconomic (e.g., the high cost of drugs), health care system (e.g., patient-provider relationships), therapy-related (e.g., adverse side effects), and condition-related (e.g., no longer experiencing symptoms).
Regardless of the underlying reason, medication non-adherence has adverse effects on the health of patients, and can be particularly harmful in elderly populations. By straying from their medication regimen, patients experience ineffective treatments and a lower quality of life by extension.
From a business standpoint, pharmacies also stand to lose when patients don’t stick with their medications. Medication adherence is a large part of the performance metrics pharmacies are measured against to calculate DIR fees. A high adherence level could lead to lower DIR fees for a pharmacy. Therefore, increasing patient retention and adherence serves to improve your pharmacy’s bottom line.
The decision to stay on a medication ultimately lies with the patient, but there are a few measures you can implement to increase the chances that your patients remain adherent.
How to tackle non-adherence
The complex problem of non-adherence calls for more individualized approaches tailored to a patient’s needs since the reasons for non-adherence vary from patient to patient. As a pharmacist, you should strive to build trust with patients through effective communication and proactive interventions. After all, you may be the last face-to-face interaction they have before deciding to take their medication.
One way to address this issue is to take advantage of the available technology to detect adherence rates and prioritize patients who would benefit most from planned interventions. On our platform, for instance, our “Low Adherence report” filters patients who are not refilling their prescriptions to help pinpoint those whose actions (or lack thereof) have the greatest effect on your pharmacy. This can help you decide who to reach out to first, taking into account the patient’s medical conditions, current medications, and the DIR impact on your business.
Once you’ve identified patients at the risk of low adherence, you can decide the best approach to help them get back on track.
Patient education also goes a long way toward helping improve adherence. Patients often experience adverse side effects that deter them from their medication regimens. In many cases, OTC supplements or other therapies can help mitigate some of these symptoms. Having a pharmacist identify possible drug interactions, make relevant recommendations, and educate them about the importance of taking their medications increases the likelihood that patients continue taking their medication.
Many pharmacies implement Medication Synchronization programs (Med Sync), which allow you to look at a patient’s medications and coordinate refills for pick up on a single day each month. According to the American Pharmacists Association, 80% of patients are more likely to take their medications when enrolled in a Med Sync program. This is convenient for patients with multiple ongoing medications, as they don’t need to make multiple trips to the pharmacy. Med Sync provides you with a recurring opportunity to check in on your patients and consistently build on your relationship.
Finally, maintaining personal relationships with patients is crucial to implementing patient-centered care. Ongoing communication like sending tailored text reminders to patients can encourage medication adherence. According to a 2016 meta-analysis, text messaging was found to double the chances of medication adherence and improved overall adherence rates by 17.8%. To maintain consistency, consider automating phone calls and text messages that remind patients about refills past due. Some other measures that can help develop strong relationships with patients include messages wishing them a happy birthday, thanking them for their first fill, and offers to win back patients who may be slipping away.
By building trust with patients and simply showing you care, patients are more likely to seek your guidance about treatments and listen when it matters. Incorporating a personal touch in treatment goes a long way in improving medication adherence.
