The development and proliferation of prescription medications is perhaps one of the greatest medical and scientific achievements in history. Imagine where we would be without the advent of antibiotics, statins, asthma medications, and other lifesaving medications. Not only have prescription medications increased the average lifespan dramatically, but they allow us to maintain a higher quality of daily life. However, even the most effective medications only work when they are consistently filled and taken as prescribed—sounds simple, doesn’t it? Enter medication adherence. Medication adherence is critical to ensuring that a patient’s prescription is as effective as intended. Generally, medication adherence of 80% or greater is required for the medication to be effective. Let’s explore the current state of medication adherence in the United States healthcare system, its challenges, and how we can work to improve it.
Medication adherence today
According to an article from US Pharmacist, medication adherence can have a greater impact on a patient’s health outcomes than the treatment itself. What does that mean? Consistently taking a medication as it was prescribed could matter more for your health than your prescriber’s choice of medication itself. Most patients don’t truly comprehend the importance of taking their medications as intended; in fact, it’s estimated that 125,000 deaths in the US each year can be attributed to medication nonadherence—not to mention up to half of treatment failures and a quarter of hospitalizations every year. It’s clear that medication nonadherence is an epidemic in the US but not only is it hurting our health, it’s raising the cost of healthcare, too—with an estimated $100 billion to $300 billion tied to nonadherence.
Medication adherence in complex populations
We’ve explored medication adherence broadly, but how does it impact populations with chronic conditions, advanced age, or those with mental health conditions?
Let’s take diabetes as an example. It is one of the most chronic health conditions in the United States with about 13% of US adults estimated to be diabetic in a 2020 report from the CDC. It’s no surprise that studies have shown that when diabetic patients have low medication adherence, their health suffers greatly. Poor medication adherence for patients with diabetes can create difficulty controlling blood sugar, which has downstream effects including decreased quality of life, increased hospital visits, and premature death.
One of the patient populations suffering the most from the effects of medication nonadherence are older adults. Older adults are more likely to have poor medication adherence rates due to factors like confusion caused by numerous medications being prescribed, low health literacy, and financial challenges related to affordability. It’s not hard to imagine how a senior with multiple chronic conditions would suffer from inadequate adherence to their medication regimen—symptoms could worsen, disease states could progress and the need for more costly hospital care could present itself.
What about the effects of nonadherence in patients with mental health conditions? Despite mental health conditions having less physical manifestation on the body, remaining adherent to mental health medications is just as important as with other drugs. Unfortunately, medication adherence in mental health patients is a difficult issue to correct, with more than half of patients not properly following their medication regimens as prescribed. In mental health patients, relationship building between patient and clinician is critical because nonadherence often originates from a distrust in the healthcare system and/or the competence of the care team.
How access to clinical pharmacists can improve adherence
It’s clear that medication is a critically important piece of the healthcare puzzle that many patients struggle to understand. So how can we all work to improve medication adherence rates to keep patients healthy and out of the hospital?
Let’s look at healthcare’s underdogs, pharmacists!
When most people imagine a pharmacist, they visualize someone in a white coat standing behind a counter at their local grocery store or pharmacy, dispensing medications to a long line of people. While dispensing is certainly a traditional career pathway pharmacists can choose, there are many more applications for pharmacists in healthcare today.
Clinical pharmacists are the foremost experts on medications within healthcare. In the same way that a patient may have a cardiologist who specializes in caring for heart conditions or a gastroenterologist who specializes in digestive conditions, there are pharmacists who specialize in the treatment of particular conditions using pharmaceutical medications. These pharmacists are highly knowledgeable in the medications in which they specialize, with expertise in side effects, drug interactions, and identifying duplicative medications.
If we’re trying to improve medication adherence, doesn’t it make sense to use the number one medication experts in healthcare? Pharmacist-led clinical consultations have been shown to improve patient adherence to medication plans for several reasons:
- Clinical pharmacists are generally more trusted by patients and therefore able to empathetically educate patients about the proper use of their prescriptions.
- When using a telephonic clinical pharmacy platform, like Aspen RxHealth, pharmacists can proactively reach out to patients to counsel on medications and ensure that they remain adherent.
- If a patient is hesitant to take a medication because it’s causing side effects, a clinical pharmacist can efficiently document that information and engage their prescriber to make appropriate changes to the drug regimen.
- Aspen RxHealth pharmacists are expertly trained in motivational interviewing, a practice that encourages clinicians to meet patients where they are, delivering a friendly and helpful approach, rather than a parental or scolding attitude when counseling in appropriate medication use.
What kind of organizations can partner with clinical pharmacists to engage patients and keep them healthier? Aspen RxHealth works with health plans, provider groups, and other strategic partners including pharmacy benefit managers, to conduct outreach to their members and patients and encourage adherence to their medication regimens.