Medication Adherence Is an Important Part of Staying Well

It is the health crisis we rarely talk about: non-adherence to prescribed medications. Poor medication adherence is believed to be the cause of approximately 125,000 deaths and at least ten percent of all hospitalizations each year, according to a report in the Annals of Internal Medicine. The report estimates that non-adherence costs the U.S. healthcare system between $100 billion and $289 billion annually. Here’s what you need to know about medication adherence and why it’s an important part of staying well.

What is Medication Non-Adherence?

Simply put, medication non-adherence is not taking a prescription medication as prescribed. Examples include skipping doses to save money, taking extra doses to feel better sooner, stopping a prescription before it runs out, or just not filling a prescription at all. Issues with medication adherence are way more common than you might think.

According to the Annals of Internal Medicine, 20 to 30 percent of prescription medications are never filled, and approximately 50 percent of medications for chronic disease are not taken as prescribed. The New York Times recently reported that people who do take prescription medications — whether it’s for a simple infection or a life-threatening condition — typically take only about half the prescribed doses:

• One third of kidney transplant patients don’t take their anti-rejection medications
• 41 percent of heart attack patients don’t take their blood pressure medications
• Half of children with asthma either don’t use their inhalers at all or use them inconsistently

For these patients, there are very real and dangerous consequences to not following their doctor’s treatment instructions, and yet they (or their caretakers) choose not to anyway.

Reasons Why Patients Do Not Adhere to Their Medication Schedule

Some of the most common reasons for medication non-adherence include:

• Cost of treatment (e.g. skipping insulin doses when money gets tight)
• Misconceptions about treatment goals and risks (e.g. “I feel better, so it is probably okay if I stop taking my medicine”)
• Desire to treat things “naturally” or to minimize the use of prescription drugs (e.g. skipping doses of asthma medication so your child isn’t “always on drugs”)
• Embarrassment or shame, particularly around the stigma of treating a mental health condition (e.g. not wanting to be a person who needs to treat depression)

Ways to Encourage Medication Adherence

Experts in the healthcare industry are working hard to come up with effective, specific ways to improve adherence. Key strategies include:

1. Addressing prescription cost concerns

   Patients, doctors, and pharmacists need to have frank discussions about any challenges a patient may have affording a specific course of treatment. The more patients understand the options they have – including alternative or generic medications , prescription discount programs , etc. – the more likely they are to adhere to treatment.

2. Improving patient education

   Patients need to understand why they are taking a particular medication, how they are supposed to take it, and what will happen if they will stop treatment. Too often, patients do not have a clear understanding of what could happen if they stop or modify their doses without consulting with their doctor or pharmacist. This is doubly true for mental health medications , where withdrawal symptoms are a possibility. A conversation can make a real difference for patients who think they can innocently skip a refill with no repercussions.

3. Exploring creative solutions

   One study in South Africa used text reminders and “treatment partners” (pairing of a patient with another person) to help encourage medical adherence in the treatment of serious mental conditions. Their results showed that creative solutions could work in well in low-income, high-risk communities.

May is Mental Health Awareness Month , and for many people, medication adherence is a key component of their wellness plan. If you or a loved one take medication to treat a mental health condition, use this month as a reminder to have frank discussions with your doctor and pharmacist about following your prescribed treatment. Medication adherence is an important part of staying well.

Sources:

• New York Times, The Cost of Not Taking Your Medicine, April 17, 2017
• Annals of Internal Medicine, Interventions to Improve Adherence to Self-administered Medications for Chronic Diseases in the United States: A Systematic Review, December 4, 2012
• Improving adherence in mental health service users with severe mental illness in South Africa, November 9, 2017
• JAMA, Pragmatic trial of health care technologies to improve adherence to pediatric asthma treatment, April 2015