Innovations-Magazine-February-2023 - 8

Breaking the Cycle of
Medication Nonadherence
P
atients may suffer preventable hospitalizations and deaths if they do not take their
prescriptions as directed and their chronic diseases are left untreated. Indeed, the World
Health Organization reports that failure to take prescribed medication for chronic diseases is
a massive, worldwide problem. In the United States and Canada, adherence to chronic medications
is only about 50%, though adherence rates of 80% or more are needed for optimal therapeutic
efficacy, according to U.S. Pharmacist and the Canadian Pharmacists Journal.
All told, nonadherence costs the US more than $500 billion, the
equivalent of 16% of total US health care expenditures, every year,
according to Patient Safety and Quality Healthcare.
Medication nonadherence is a persistent and complex issue, but
today, there are more ways to combat it than ever before through
technology and the expanded role of pharmacists.
Causes of Nonadherence
The cost of medication itself is one of the biggest causes of
nonadherence. As the US continues to contend with the coronavirus
disease 2019 pandemic, incomes are often not keeping pace with
inflation and the rising cost of living. In this sort of economic
environment, patients might feel pressure to ration their prescriptions or
skip filling them to save money.
Some of the first prescriptions neglected by many patients are
maintenance medications for chronic diseases such as diabetes or
cardiovascular disease, which are critical to maintaining the longterm
health of patients. When patients who cannot afford medication
decide to reduce its frequency or skip it altogether, they drastically
reduce the effectiveness of their medical treatment.
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Other causes of nonadherence may be unintentional. Some patients
might fail to take prescriptions as directed because they are stymied by
complex treatment regimens. Older patients or those suffering from earlyonset
dementia might need more help from an aide or caregiver, who can set
up weekly pill boxes or some other intuitive system to keep pills organized.
Medication nonadherence also may signal health inequities
that lead to health disparities within communities. Such causes of
nonadherence include:
* insufficient patient education or lower health literacy;
* lack of patient access to quality health care; and
* lack of patient access to neighborhood pharmacies
(ie, pharmacy deserts).
The Role of Pharmacists and Technology
Pharmacists garner a high degree of trust with patients - they typically
rank in the top five most honest and ethical professions according to
Gallup polls - and given that they possess the necessary education and
training, they are logical partners in counseling patients and engaging
underserved communities in support of improving medication adherence
and accessibility of care.

Innovations-Magazine-February-2023

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