Treatment Nonadherence: The Real Impact on Populations

The healthcare ecosystem battles adherence to medication and care plan treatment everyday. Understanding the various cause/effect relationships and health implications for certain patient populations is challenging, and has become a focus of many industry organizations. With innovations in digital health further opening the doors of possibility, it may be the answer we’ve been looking for.

Medication use and healthcare costs have increased dramatically during the previous decade in the United States. In 2009, the number of prescriptions dispensed was nearly 3.95 billion, while in 2019 the number of prescriptions dispensed was around 4.38 billion. Even though roughly 80% of all patient-provider interactions in the United States end with at least one prescription, patients still struggle to take medications as prescribed. Medication nonadherence is a big problem.

The costs of nonadherence

A recent paper published in The Annals of Pharmacotherapy titled “Cost of Prescription Drug-Related Morbidity and Mortality” analyzed the total costs of “non-optimized prescription drug use and average pathway costs for a patient who experienced a treatment failure (TF), a new medical problem (NMP), or a TF and NMP.” The study estimates that:

  • The annual cost of prescription drug-related morbidity and mortality resulting from non-optimized medication therapy is $528.4 billion in 2016, with a plausible range of $495.3 billion to $672.7 billion.
  • Non-optimized drug therapy results in about 275,689 deaths per year.

Medication nonadherence is a high priority, preventable health problem that leaves us with a highly preventable gap in the care continuum. The World Health Organization notes that the average nonadherence rate is 50% among those with chronic illnesses. How does a provider ensure that their youngest patients are taking their medications as prescribed? How can a family member ensure that their elderly mother has remembered to refill her prescriptions?

Greater engagement = greater adherence

The relationship between providers and patients and open, ongoing communication between stakeholders are essential to building greater engagement and combating medication nonadherence.  

The development and use of mobile health tools provides an opportunity to connect patients with healthcare providers outside of the clinical setting, creating a transparent partnership towards chronic disease management. When patients feel comfortable talking to their providers, the chances of them forgetting to pick up refills are reduced and they’re less likely to skip doses. They can better understand the importance of taking their medication and the implications if they don’t. 

In addition, digital health technologies can monitor patient results and assist providers in making better and quicker decisions about doses and scheduling. The more than 90 million patients who struggle to understand and act on the health information they’re provided can play a more educated, engaged role in their health, and therefore more likely adhere to their care plan.

Collaboration is key: Engaging pharmacists and other players

Expanding medication management programs overseen by clinical pharmacists and collaborating with physicians and other prescribers can mitigate nonadherence and improve patient outcomes. Pharmacists are often the last healthcare professionals that patients interact with in the drug chain process, giving them the ideal predisposition and capacities to provide certain digital health services.

Consider a mobile app that automatically uploads patient data from health and wellness devices alongside medication tracking. Speciality pharmacists and care teams can watch adherence in real-time and intervene if a patient isn’t following directions or if a problem occurs. In addition, they can view medication history, health indicators, and trends over time to target inappropriate medication use, potential drug-related problems, and care plan adherence.

Using an engaging digital health system to keep medication adherence at the forefront of patients’ minds means they’re more likely to be adherent, which improves their health and reduces other associated costs. 

Industry trends and implications

Nonadherence costs pharmaceutical companies billions, but is also costing providers who may be unable to meet accountable outcomes such as hospital readmission rates, physician quality reporting system measures, or Medicare star ratings. For this reason, industry giants like Pfizer and Merck, as well as the Pharmaceutical Research and Manufacturers of America, are eager to implement robust medication implementation programs. Unfortunately, they are often faced with organizational barriers such as an inability to develop a clear ROI and insufficient budgets. 

With digital health platforms, pharmaceutical companies can monitor efficacy, adherence, and access real-time data regarding their patients. Payers can reduce healthcare costs and subsequent premiums. The incentives to engage in holistic healthcare are tenfold for these stakeholders and mobile health technologies provide a consistent, accessible solution to these problems.

What next?

Our approach needs to be both multifaceted and flexible in response to the most common barriers in the way of adherence. The healthcare industry could save $290 billion a year by using mobile health technology. The challenge now is configuring medication management in a way that allows patients to seamlessly integrate it into their daily life. This requires an inexpensive, user-friendly interface for patients combined with clinical validation for providers.

At Veta Health, adherence is just a portion of our holistic view towards patient-centered care. We’re looking forward to addressing these challenges with our digital solutions for integrated self-managed care that allow patients and providers to co-produce better outcomes. The investment into healthcare technologies is the beginning of achieving our nation’s short and long-term goals regarding patient and value-centered care.

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