If you’re like the majority of Americans, you’ve been prescribed at least one daily medication. And if you’re like the majority of the daily-medication population, you’ve failed to be perfectly adherent to your doctor’s and pharmacist’s orders. Adherence – generally defined as a patient correctly taking at least 80% of the doses prescribed to them – isn’t easy.[1] Even when a prescription becomes routine, every patient runs the risk of missing a dose or administering the medication improperly. At ScriptDrop, we are constantly innovating solutions that fit perfectly into an overall solution to help tackle the issue of non-adherence. That’s why it was important to take a deeper look at the problem at hand.
The causes of non-adherence are wide-ranging and multidimensional. The patient’s diagnosis – and any comorbidities, such as physical disability or mental health concerns – may affect their willingness or ability to be adherent. Patients must also be prepared with information regarding the cost, side effects, and potential inconveniences of the drug regimen, as those elements may present an obstacle depending on the patient’s socioeconomic and emotional situation. For example, a patient on a fixed income will struggle with adherence if their medication costs several hundred dollars a month. A patient afraid of needles will need additional training to administer insulin to themselves. And an asymptomatic patient who isn’t convinced that they’re sick may never take the first dose at all. Combine any number of these factors and the chances of adherence fall dramatically.
The first order of business for providers, then, is to remind themselves that non-adherence is an ongoing challenge for American healthcare and a worthy concern for the industry. Studies wager that non-adherence causes 100 to 300 billion dollars of preventable health costs per year in the United States, which is a sizable portion of total healthcare spending.[2] But far more important than the remarkable economic cost of non-adherence is the vast amount of suffering it causes. Patients can experience a worsening of their condition, hospitalization, or even death. While it rarely appears as cause of death on death certificates, it is estimated that 125,000 people die per year due to medication non-adherence.[3]
In the face of such a complex problem, healthcare providers might feel defeated – but there is a lot that can be done. Providers can begin by asking their patients about their specific health needs and tailoring treatment plans to ensure adherence. This is especially important if the patient has a chronic or poorly-defined condition and will be on treatment for an extended period of time, or if the medication is particularly expensive, is difficult to administer, or has serious side-effects. In addition, provider offices could use portal technology or text messaging to encourage self-reporting of adherence and symptoms or could encourage patients to keep medication diaries.[4]
We still have a lot to learn when it comes to medication adherence; it is not a problem with a simple solution, but one the healthcare industry must keep in their sights for the foreseeable future. Improved adherence can only happen when patients and healthcare providers work together, but it’s worth every effort. At ScriptDrop, we are committed to doing everything we can to ensure patients have a safe and efficient way to receive their medications.
[1] Kleinsinger, Fred. “The Unmet Challenge of Medication Nonadherence.” The Permanente journal vol. 22 (2018): 18-033. doi:10.7812/TPP/18-033
[2] Zullig, Leah L., Hayden Bosworth. ”Engaging Patients to Optimize Medication Adherence.” NEJM Catalyst (May 14 2017): https://catalyst.nejm.org/optimize-patients-medication-adherence/
[3] Kleinsinger, Fred. “The Unmet Challenge of Medication Nonadherence.” The Permanente journal vol. 22 (2018): 18-033. doi:10.7812/TPP/18-033
[4] Basu, Saurav et al. “Improving the assessment of medication adherence: Challenges and considerations with a focus on low-resource settings.” Ci ji yi xue za zhi = Tzu-chi medical journal vol. 31, 2 (2019): 73-80. doi:10.4103/tcmj.tcmj_177_18