Are you one of the 70 percent of Americans who take at least one medication daily? If so, then there’s a 50 percent chance you’re also one of the ones who don’t take it as prescribed.
More than 131 million adults in the United States use prescription medication, and over four billion prescription drugs are dispensed annually. Although these medications offer an effective method for treatment, many patients don’t take their prescribed medication as directed – even those with chronic diseases. These statistics speak for themselves:
- About half of patients with chronic diseases don’t take their medication as prescribed.
- More than 20 percent of new prescriptions are never filled.
- Roughly 63 percent of physicians report that at least one in four patients don’t take medication as prescribed.
- Approximately 30 percent of people with diabetes report missing at least one dose of oral antihyperglycemic medication per month.
- Data suggests that non-adherence occurs in 45.2 percent of all hypertensive patients.
- Older adults are often at higher risk for nonadherence as they are more likely to be on multiple prescription medications.
How is Medication Nonadherence Defined?
This lack of following prescription instructions — including taking more or less medication than prescribed and/or taking it at the wrong time — is referred to as medication non-adherence. According to the American Medical Association (AMA), a patient is considered adherent if they take 80 percent of their prescribed medicine and nonadherent when they take less than that percentage.
As the number of medication doses per day increases, so does the level of nonadherence. Some patients won’t even fill a prescribed medication. Or, they’ll take one without informing their physician. You might be surprised to learn that younger individuals typically have worse medication adherence rates than the elderly.
Medication adherence is a component of treatment adherence, which is defined by the World Health Organization (WHO) as the extent to which a person’s behavior corresponds with the agreed recommendations from a healthcare provider. Along with medication, treatment adherence can be applied to exercise, diet and other recommended lifestyle changes.
Adherence is crucial to positive health outcomes and treatment efficacy. However, up to 80 percent of patients drop out of their chronic care management plans.
Reasons Patients Don’t Take Medicines Prescribed
Why do so many patients fail to follow their physicians’ instructions? There are a variety of reasons, and not all are intentional.
For example, some individuals simply forget to take their medication, which then becomes a habit. In fact, that forgetfulness is one of the most common causes of non-adherence. Studies have consistently found that patients do not correctly recall much of the information given by their physicians, and only about half the items they do remember are inaccurate.
Other patients stop taking their prescriptions because of unpleasant side effects, even if they’re only temporary. Or, they might start to feel better and no longer feel like taking the medication is necessary.
Social determinants of health (SDOH) come into play with adherence. Low socioeconomic status patients adhere less well to treatment and medication, on average, and the prevalence of medication nonadherence is higher among underserved populations.
Other barriers to the effective use of medicines specifically include poor provider-patient communication, inadequate knowledge about a drug and its use, not being convinced of the need for treatment, long-term drug regimens, complex regimens that require numerous medications with varying dosing schedules and high costs. Patients with low health literacy are at an even greater risk for medication and treatment nonadherence because of difficulty understanding the corresponding instructions.
Consequences of Medication Nonadherence
Poor medication adherence can result in serious — and fatal — consequences. In addition to being associated with higher rates of hospital admissions, suboptimal health outcomes and increased morbidity, medication nonadherence is estimated to be linked to 125,000 deaths annually.
Then there’s the cost of nonadherence for the healthcare industry. As noted by the Centers for Disease Control and Prevention, direct healthcare costs associated with nonadherence have increased to approximately $100–$300 billion of U.S. healthcare dollars spent annually.
Other consequences of nonadherence include waste of medication, disease progression, reduced functional abilities, lower quality of life and increased use of medical resources. In some cases, medication adherence can have a more direct impact on patient outcomes than the specific treatment itself.
Research on the Advantages of Medication Adherence
If you want research showing the importance of medication and treatment adherence, there’s an abundance of it. Following are just a few examples:
- Adherence to prescribed medications is associated with improved clinical outcomes for chronic disease management and reduced mortality from chronic conditions.
- Every one percent improvement in adherence saves about $50 in healthcare spending.
- For patients with chronic conditions like hypertension or diabetes, patients who took their medications as prescribed saved an average of between $4,000 and $8,000 per year on healthcare costs.
- Adherence to lipid-lowering medications has been associated with a 25 percent decrease in the risk of cardiovascular disease.
Using Digital Health Tools to Promote Medication Adherence – Especially in Patients with a Chronic Disease
Along with helping patients access healthcare and doing so conveniently, digital health tools can be utilized to help improve medication adherence. They provide patients with prescription information readily available at any time through the use of patient portals and enable individuals to efficiently communicate with their provider with any questions about their medication regimen.
By promoting more effective communication, digital health technology enables providers to more easily share tips on medication management and possible prescription side effects and interactions. Even these simple forms of engagement and outreach can help motivate patients to follow medication instructions and recommendations.
Another digital health tool useful for healthcare providers in promoting medication adherence is HIPAA-compliant two-way text messaging. The Community Preventive Services Task Force (CPSTF) recommends the use of text messaging interventions to increase and improve medication adherence among patients with chronic medical conditions, and evidence from a systematic review shows interventions lead to meaningful improvements in short-term rates of medication adherence.
Studies have shown that text messaging approximately doubles the odds of medication adherence, increasing rates from 50 percent to almost 68 percent. These messages can be automated for delivery at scale for tailored and personalized patient communication, especially for those with at least one chronic medical condition.
Schedule a demo of CareCommunity to see how to enhance your patient outreach.