For PBM’s, health plans, and physicians, the key to improving care quality and reducing healthcare costs is encouraging patients to stay in compliance with medication and health care regimens. However, the reality is that patient non-compliance is a continuing challenge for all health care stakeholders. Numerous studies estimate the medication non-adherence costs $100 – $289 billion a year in the United States and the anticipation is that these numbers will continue to grow in the future.
The reasons for a lack of compliance with medication and health regimens have been studied on a global basis to find commonality for non-compliance regarding a number of chronic diseases. From treatment compliance of hypertension in Africa to determining the factors that cause increasing non-compliance across different medical conditions, researchers have studied the differentiating factors related to improving patient compliance.
In the course of these studies, there are three factors determined to have the most important effect on patient compliance with prescribed medications. These factors are:
Understanding of medical directions
According to the United States Department of Health and Human Services, one of the most important factors in medication compliance is that patients must understand what they are supposed to do before they follow medical recommendations. Additional studies have shown that the risk of non-adherence to medical recommendations is extremely high when patients either cannot understand basic medical instructions or their health provider has not given them the proper information to follow medication protocols that are prescribed.
A study of asthma patients underscores the importance of having the proper information about how their chronic conditions are addressed by their medications. The study showed that only 38% of the patients adhered to their medication regiment, while the remaining 62% indicated that they believed that they were only to take their medication when they were showing asthma symptoms, instead of an ongoing regimen that was prescribed. Additional related studies showed that ineffective patient-physician communication, including physicians not fully explaining the benefits related to drug treatment, led to less effective compliance.
Involvement in the Process
Many patients who are non-compliant feel uninvolved in their care process or do not have a support system to help them stay on track with their daily medication use. Studies have shown that both patient satisfaction and adherence to medication regiments are often intrinsically tied to their physician’s encouragement for the patient to be actively involved in their condition diagnosis and their medication planning. One study also showed that when patients feel that their physician is trustworthy, patients’ intentions to follow the physician’s recommended treatments are higher.
Compliance reminders
Compliance reminders to take medication for chronic conditions have shown outstanding results for increasing medication compliance, which leads to more positive patient care outcomes. A University of Chicago Medicine pilot program using text message reminders for diabetes patients has shown success for enhancing patient support and self-care for chronic conditions. The program showed promise for patients, with an average decrease of HbA1c levels from 7.9 percent to 7.2 percent, while individuals who had the most poorly controlled HbA1cdropped their levels from 10.3 percent to 8.5 percent in only six months.
The University of Chicago Medicine text messaging program showed a “significant decrease in health care costs compared to the pre-test period. The total cost of care declined $812 per participant, reflecting a savings of $1,332 in inpatient, outpatient and emergency department visits, offset by a $520 increase in drug costs. 73 percent of participants said they were satisfied with the program, with 88 percent pointing to interaction with a health professional as an important factor in their engagement.”
In addition to this program, a recent randomized clinical trial evaluating mobile telephone text message intervention to promote medication adherence in adults with chronic disease was published in the Journal of the American Medical Association (JAMA) and revealed these key findings:
- Mobile phone text messaging nearly doubled the compliance rate for patients in the study
- The adherence rate improved from 50% to 67.7%; an absolute increase of 17.8%
As PBM’s, health plans and healthcare providers look for ways to minimize the costs of medication non-compliance, utilizing a multi-tiered communication program to encourage patient engagement with their physicians and other key care givers could achieve both better outcomes and lower costs. To assist with reducing the costs of non-compliance and to drive higher levels of a patient medication adherence, RxEOB offers a range of products that drive more consistent and rewarding patient engagement for our clients and their patients. To find out how RxEOB can assist you, please contact us at 888-648-0989 ext. 226, or email us at info@rxeob.com.
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