By Adherence to medications remains one of the foundations for the management, treatment, or even cure of disease. In fact, in an abstract in US Pharmacist, following the prescription may directly affect the patient’s outcome than the individual treatments.
And yet, medical non-adherence is one of the biggest challenges in healthcare. According to statistics, the compliance rate among people with chronic illnesses is a dismal 50%. For a medication to “work its magic,” a patient’s commitment to the regimen should be at least 80%.
Not following the doctor’s instructions can lead to terrible consequences. It now accounts for over 120,000 deaths in the United States and not fewer than 25% of hospitalizations. Non-adherence also leads to half of the treatment failures.
What prevents a patient from taking their medications religiously? The answer is a combination of causes and risk factors.
- Problematic Prescription Process
Usually, when it comes to medication non-compliance, the blame ends up on the patient. However, a study in the Mayo Clinic Proceedings revealed that three factors influence medication-taking behavior: patient, healthcare provider, and process. Issues in any one of these can increase the risk of poor prescription compliance.
Take, for example, the issuing of prescriptions. Often, the patient sees their doctor, who then gives them a list of drugs to take. They then go to the pharmacy, which processes the request.
The problem comes in when the patient honestly loses their prescription. If it is a controlled substance, they need to see the physician again. If it is a routine medicine, they may have to pay the cost out of pocket if they want an early refill.
In both situations, the process of dealing with lost prescriptions becomes more cumbersome and even more expensive.
For this reason, many health experts encourage doctors and facilities like hospitals to invest in technologies like patient portal solutions. A comprehensive platform allows patients to store electronic prescriptions and reach out to their doctors without seeing them face-to-face.
In fact, in the US Pharmacist study, a review of the randomized controlled trials showed that indirect interventions such as electronic processes could be just as efficient as in-person appointments to improve medication adherence. They even posted a higher success rate of 56% compared to 52% of face-to-face models.
- Aging
Many studies correlate medication non-compliance and aging. For instance, in a 2018 report, the researchers cited that nearly 70% of hospitalizations involving seniors were either potentially avoidable or completely avoidable if they appropriately took their medications.
But taking medications promptly and correctly can be challenging for those already in the geriatric age:
- They are likely prescribed a lot of medicines. On average, they may need to consume between six to eight types of drugs for various chronic illnesses. It then increases the risk of overdose, skipping, and drug interactions, leading to adverse side effects.
- Older people are susceptible to age-related memory loss. Aging is also a major risk factor for cognitive impairment conditions such as dementia or Alzheimer’s disease.
- Seniors are likely to suffer from poor mobility or dexterity. They may no longer have a firm grip or struggle to walk, making trips to doctors and pharmacies a chore.
- No Insurance or Lack of Insurance Coverage
Medications in the United States are expensive. Estimates suggest that an individual spends an average of $1,200 a year on these substances. Worse, experts forecast that healthcare spending will only increase in the future as Americans live longer.
Insurance coverage can be a big help. Sadly, at least 8.5% of the population or almost 30 million Americans didn’t have health insurance in 2018, the Census Bureau revealed. The COVID-19 pandemic may only increase the number as people lost their jobs.
For those with insurance, some percentage may be underinsured. Their coverage may not be enough to pay for their medications’ total cost, or the out-of-pocket costs remain significant. Patients, therefore, may choose to skip taking medicines to save money.
- Lack of Symptoms
Patients may take some medications on a per-need basis—that is, only when symptoms worsen or recur. Meanwhile, some drugs require complete adherence whether the person experiences more symptoms or they have already resolved.
Non-compliance usually increases once the patient “stops feeling anything” or they feel well. They don’t know whether they only boost the odds of recurrence or, worse, other health problems such as antibiotic resistance.
Medical experts call poor medication adherence the elephant in the room. While it is common, it is also extremely challenging to manage. But helping patients remain compliant can not only save a life but relieve the healthcare system of a huge economic and social burden.
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