The Advent of Adherence

Tips and statistics surrounding the challenge of medication adherence.

To some, remembering to take one’s medications may seem like a small problem—not comparable to serious medical issues like nicotine addiction or the dangers of second-hand smoke. But with 44% of men and 57% of women over 65 on 5or more medications, adherence isn't a simple problem at all, and will impact every person at some point in their lifetime.

Medication non-adherence can result in costly hospital readmissions, medical complications, declines in wellness/quality of life, and the need for additional care. Due to these factors, additional awareness about this serious public health issue is crucial moving into 2015.

Pharmacists are undervalued as patient care providers—one of the best ways they can reclaim this role and make themselves invaluable to their patients is by keeping patients adherent to their medications. MTS Medication Technologies created this list to educate pharmacists–and their patients–about the severity of medication non-adherence so that another year doesn't fly by without addressing this problem.

• In the US, avoidable healthcare costs add up to $213B, of which $105B is due to medication non-adherence.
• The World Health Organization (WHO) states that one-in-four adults have two or more chronic health conditions.
• Non-adherence causes 30-50% of treatment failures and 125,000 deaths annually.
• Offer a med sync program: 23% of medication non-adherence is due to patients forgetting to refill their meds.
• 64% of readmissions within 30 days are due to medication issues.
• 48% of Medicare Star Rating measurements are related to medication adherence in some manner.
• Since 2006, cuts to reimbursements have cost pharmacies ~$15B in lost revenue.
• When using multi-med blister cards, patient confidence in taking their meds increases from 7% to 93%.
• Medications are not continued as prescribed in about 50% of cases.
• Even if you offer adherence packaging, reminder services are a great addition. Patients who use electronic reminders report fewer barriers to adherence.
• Nearly 50% of Americans have 1 or more chronic conditions that require prescription medications.
• One third to two-thirds of medication-related hospital admissions are linked to poor adherence.
• Medication adherence is higher among patients who see the same health care provider each time they have a medical appointment. In this group, the average adherence is 81%.
• 3 out of 4 Americans do not take medications as directed.
• The most common reason patients give for failing to comply with doctor’s orders is forgetfulness, cited by more than 4 in 10 as a major reason.
• Of the approximately 187 million Americans who take one or more prescription drugs, up to one-half do not take their medications as prescribed.
• Not taking medications as prescribed costs over $100 billion a year in excess hospitalizations.
• More than 2,600 hospitals will together forfeit about $428 million in Medicare funds over the next year (starting in October 2014) due to their readmission rates.
• Nonadherent patients are 17% more likely to be hospitalized than adherent patients, with a cost that exceed that of an adherent patient by $3575.
• 93% of patients using multimed blister cards stated that the package resolved adherence issues and improved their quality of life.
• Generic medications have higher rates of adherence than name brand prescriptions, with 77% of patients adhering to generics as opposed to 71% with the name brand.
• Last year, nearly 18 percent (roughly 3 million) of Medicare patients who had been hospitalized were readmitted within a month, costing Medicare $26 billion in additional hospital bills.
• 62% of physicians agree that “my patients are taking so many medicines that it’s hard for them to take all of them properly.
• For some classes of medication, up to 30% of prescriptions are never filled by the patient.
• Medication non-adherence costs $2000 per patient in physician visits annually.
• Up to 50% of patients leave the doctor’s office without understanding their medication directions.
• Over 35% of Medicare-insured patients would be interested in using mail-order pharmacy services to obtain their medications.
• Patients receive 3.4 more refills per prescription in a 12 month period when their refills are synchronized.

References:

• Express Scripts 2013 Drug Trend Report. http://lab.express-scripts.com/~/media/7f14884da6ef434dbf30abd82dd7e655.ashx. Accessed November 20, 2014.
• Ward BW, Schiller JS, Goodman RA. Multiple chronic conditions among US adults: a 2012 update. Prev Chronic Dis. 2014;11:130389.
• Smith D, Compliance Packaging; a patient education tool, American Pharmacy, Vol. NS29, No 2, February 1989.
• BCG Analysis, Patients Survey in Pharmacy Management. http://www.bcg.com/documents/file14265.pdf. Accessed November 25, 2014.
• 2010 Benchmarks in Improving Medication Adherence. Healthcare Intelligence Network, May 2010.
• American Pharmacists Association, Academy of Managed Care Pharmacy. Medicare star ratings: Stakeholder proceedings on community pharmacy and managed care partnerships in quality. Journal of the American Pharmacists Association. 2014;54;228-240.
• National Community Pharmacists Association. (2010). The impact of recent Medicare and Medicaid cuts on patients’ access to independent community pharmacies [Press release]. Retrieved from http://www.ncpanet.org/pdf/leg/oct11/pharmacycutsfinal.pdf
• Omnicell. (2014). Patients report use of MTS blister card improves confidence in safely taking medications and reducing emergency room visits [Press release]. Retrieved from http://www.omnicell.com/News_and_Events/Press_Releases/Patients_Report_Use_of_MTS_Blister_Card_Improves_Confidence_in__Safely_Taking_Medications.aspx
• Center for Disease Control. (2013). Medication Adherence [Powerpoint slides]. Retrieved from http://www.cdc.gov/primarycare/materials/medication/docs/medication-adherence-01ccd.pdf
• American Society of Nephrology. (2014). How to get teens and young adults with chronic conditions to take their medications [Press release]. Retrieved from http://newswise.com/articles/view/625067/
• Chronic Diseases and Health Promotion from the Centers for Disease Control and Prevention. http://www.cdc.gov/chronicdisease/overview/index.htm. Accessed October 15, 2014.
• Osterberg, L., & Blaschke, T. Adherence to medication. New England Journal of Medicine. 2005; 353(5), 487-497.
• National Community Pharmacists Association. Medication adherence in America: A national report card [PDF document]. Retrieved from http://www.ncpanet.org/pdf/reportcard/AdherenceReportCard_Full.pdf
• American Heart Association. Medication Adherence Taking Your Meds as Directed. (2013). http://www.heart.org/HEARTORG/Conditions/More/ConsumerHealthCare/Medication-Adherence---Taking-Your-Meds-as-Directed_UCM_453329_Article.jsp Accessed on July 13, 2014.
• National Community Pharmacists Association. Medication adherence in America: A national report card [PDF document]. Retrieved from http://www.ncpanet.org/pdf/reportcard/AdherenceReportCard_Full.pdf
• Osterberg, L., Blaschke, T. Adherence to medication. New England Journal of Medicine. 2005;353(5); 487-497.
• Sokol, M.C., McGuigan, K.A., Verbrugge, R.R., et al. Impact of medication adherence on hospitalization risk and healthcare cost. Med Care, 2005;43(6); 521-530.
• Rau, J. (2014, October 2) Medicare Fines 2,6010 hospitals In Third Round of Readmission Penalties. Kaiser Health News. Retrieved from http://kaiserhealthnews.org/news/medicare-readmissions-penalties-2015/
• A. Dragomir et al. (May 2010.). Impact of Adherence to Antihypertensive Agents on Clinical Outcomes and Hospitalization Costs. Medical Care, 48 (418-425). doi: 10.1097/MLR.0b013e3181d567bd.
• Omnicell. (2014, March 28). Patients report use of MTS blister card improves confidence in safely taking medications and reducing emergency room visits [Press release]. Retrieved from http://www.omnicell.com/News_and_Events/Press_Releases/Patients_Report_Use_of_MTS_Blister_Card_Improves_Confidence_in__Safely_Taking_Medications.aspx
• O’Riordan, Michael. (2014, September 15). Generics Beat Brand-Name Statins for Patient Adherence and Improving Outcomes. Medscape. Retrieved from http://www.medscape.com/viewarticle/831707
• Rau, J. (2014, October 2) Medicare Fines 2,6010 hospitals In Third Round of Readmission Penalties. Kaiser Health News. Retrieved from http://kaiserhealthnews.org/news/medicare-readmissions-penalties-2015/
• “Take Meds Faithfully,” Consumer Reports Shopper’s Guide to Prescription Drugs (No. 7), 2007 https://www.consumerreports.org/health/resources/pdf/best-buy-drugs/money-saving-guides/english/DrugComplianceFINAL.pdf
• NEHI. (2014, October). Ready for Pick-Up: Reducing Primary Medication Non-Adherence (Issue Brief). Cambridge, Mass: Hubbard, Thomas E. Retrieved from http://www.nehi.net/writable/publication_files/file/pmn_issue_brief_10_14_formatted_final.pdf
• American Pharmacists Association. (2003). Medication Compliance-Adherence-Persistence (CAP) Digest. Washington, DC: APhA.
• Atreja, A., Bellam, N., & Levy, S. R. (2005). Strategies to Enhance Patient Adherence: Making it Simple. Medscape General Medicine, 7(1), 4.
• Nair, K. et al. (2011). Understanding barriers to medication adherence in the hypertensive population evaluating responses to a telephone survey. Patient Preference and Adherence. Retrieved from: http://www.dovepress.com/getfile.php?fileID=9909
• National Community Pharmacists Association. (2014). Patients Benefit from Pharmacy-Provided Medication Synchronization Programs. [Press Release]. Retreived from: http://www.ncpanet.org/newsroom/news-releases/2014/01/15/patients-benefit-from-pharmacy-provided-medication-synchronization-programs.

SOURCE: MTS Medication Technologies