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Message For Your Patient: Take Your Medicine

Sep 1, 2018

Assessing the costs of not following cholesterol treatment and possible ways to reverse medical non-adherence

Guest writer: Curaizon.com

Yes, here we are again talking about medical non-adherence. It’s a well-known issue that seems to stick around and plague our medical systems with exorbitant waste and unnecessary suffering despite the endless articles, studies, and discussions related to the subject.

According to numerous sources around the world, medical non-adherence leads to approximately $700 billion dollars’ worth of additional annual health care costs. Those wasted resources might be better used on infrastructure, education, or furthering medical research.

Yet not all incidents of medical non-adherence are made the same, and one particularly persistent case lies with medications that are used to treat asymptomatic conditions, such as high blood pressure, elevated glucose or high cholesterol. If people are not suffering from pain, fatigue, confusion, or life-threatening symptoms, it can be quite easy to forget to take medication — even if it might prevent deterioration later on down the line. Only half of patients with high cholesterol take their medication 80% as often as prescribed. That leaves 45% either not taking meds at all or somewhere in the middle where the dosage isn’t high enough to actually have any effect. These same people are, unsurprisingly, more than twice as likely to be hospitalized as a result of their condition.

In order to mitigate the effects of non-adherence, it’s first helpful to understand some of the conditions that might lead to its persistence. One of the most important of these is the well-studied phenomenon of non-adherence being positively correlated with the frequency with which patients are required to take their medications. For “one-per-dayers,” the adherence rate is nearly 80%, which drops off sharply to only 50% as soon as an additional dose is required. If medical research could work toward designing more slow release pills and medications that only need to be taken once per day, this alone could drastically reduce non-adherence among patients with asymptomatic conditions. The difference between 80% and 50% adherence alone could generate up to several hundred billion dollars’ worth of health care savings, not to mention the drastic improvement in quality and length of life.

Additionally, as much as 10% of patients considered to be non-adherent don’t even make it through the step of fulfilling their prescriptions. This presents an enormous opportunity to tackle this problem by streamlining the process of delivering medications and encouraging pharmacists to take a more active role in distributing medication. If a patient doesn’t show up to receive medication for more than a week after being discharged from the hospital, a simple phone call, text message, or otherwise active reminder could push them in the direction of adherence and thereby reduce the waste and risk we all know so well. A reminder system like this has also been shown to be highly effective when encouraging patients to take the medications they already have, with some studies reporting a 30%+ rise in adherence. Keep in mind, when we’re talking about non-adherence, an improvement of only 1% could save global health care systems billions. And while that might not seem like a lot relative to the overall system, many lives could be saved by diverting wasted resources toward those who really need it.

Finally, there is opportunity for improvement via cultivating better long-term habits for patients with chronic illnesses; patients who have type 1 diabetes, for example, typically have a very high level of insulin adherence as a result of being raised by disciplined parents who insist they not forget to take their medication or else suffer potentially life-threatening consequences. Exploring this further could lead to more robust and targeted regiments in hospitals that are designed to educate and develop good habits in patients before they are discharged or in the first few weeks that they’re home.

It’s amazing to think that one of the biggest problems in modern health care is not that we don’t have the technology to treat conditions, but rather that we have created global systems that are prone to such exorbitant waste, leading to a lack of resources for those who might otherwise benefit enormously from their use. Especially with conditions that don’t exhibit daily symptoms, medical non-adherence is an endless source of waste and unnecessary suffering in the health care industry, but the challenge of solving it should not deter us from continuing to push forward!