Looking for ideas to reduce the rise of health care cost? Easy! Ask patients to swallow their medication!
According to recent studies, the lack of prescription medication adherence cost between $250 and $300 billion annually, including $100 billion in hospitalization. For example, it is estimated that in the US 89,000 deaths annually are due to non adherence to anti-hypertensive treatments. This problem is particularly acute for patients with coexisting conditions who take a variety of medications sometimes prescribed by different physicians.
Obviously doctors and pharmacists have a critical role to encourage patients and caregivers to administrate medication correctly and rigorously.
Cost is not necessarily the main factor: even when drugs are free, adherence rate is 60% in the US and only %50 in developed countries. In other words, improvements in co-payments structures will only partially improve adherence. Another area of possible improvement will be the use of fee-for-service model.
Another way to improve medication adherence is the proper use of specific technologies:
Here are some suggestions:
Finally, we have to keep in mind, that other factors including lifestyle, psychological issues and health literacy play an important role as well. And these are not negligible!
According to recent studies, the lack of prescription medication adherence cost between $250 and $300 billion annually, including $100 billion in hospitalization. For example, it is estimated that in the US 89,000 deaths annually are due to non adherence to anti-hypertensive treatments. This problem is particularly acute for patients with coexisting conditions who take a variety of medications sometimes prescribed by different physicians.
Obviously doctors and pharmacists have a critical role to encourage patients and caregivers to administrate medication correctly and rigorously.
Cost is not necessarily the main factor: even when drugs are free, adherence rate is 60% in the US and only %50 in developed countries. In other words, improvements in co-payments structures will only partially improve adherence. Another area of possible improvement will be the use of fee-for-service model.
Another way to improve medication adherence is the proper use of specific technologies:
Here are some suggestions:
- the integration of practice EMRs systems and pharmacies via HIE solutions (a lot of practices are still using paper).
- accurate and Electronic Health records (EMRs, and PHRs) that help verify drug, herbs, supplements interactions and countraindications. The meaningful use guidelines go in this direction.
- wider use of medication home delivery (recognized as a way to save cost by introducing better competition)
- electronic monitoring systems coupled with personalized counseling has shown improvement in medication adherence rates to patients
- online incentive programs (e.g. provided by the employers) to promote prevention, quality of life and best practices in therapy. It is recognized that financial incentives and other rewards when well designed and targeted can improve adherence (smaller and higher reward frequency is usually more efficient than big and sporadic rewards).
- advances in personalized medicine can help taylored medication intake and increase medication adherence
- screening and assessment tools (e.g. patients with chronic conditions could be screened for depression leading to poor medication adherence).
- new high-tech integrated devices including:
- Home devices such as the well known high-tech Japanese toilets which provide urine analysis, blood pressure, weight and body temperature
- Radio Frequency Identification (RFID) based wireless sensor device can help track drug taking compliance
- Wireless pills organizers designed to simplify medication management and improve adherence
- Personalized wearable sensors such as the latest electronic temporary tattoo
Finally, we have to keep in mind, that other factors including lifestyle, psychological issues and health literacy play an important role as well. And these are not negligible!
