Who should be responsible for Patients’ medication adherence?


By Dr. Batami Sadan, Co-Founder and Board Member, Vaica, chair of the Israeli Association for Medical Informatics

Patient adherence to medications has been an issue challenging healthcare professional for decades. Adherence rates, causes of non-adherence, barriers and enablers to medication taking, interventions to promote adherence, and the impact of non-adherence on health outcomes, have been extensively studied.

Patients who adhered to their prescription schedules saved up to $5,341 annually in medical costs, while patients who were non-adherent cost as much as $2,763 more to treat, reported by FierceHealthcare.

While there doesn’t seem to be any question that improving medication adherence would have a positive impact on patient outcomes and healthcare costs, why does it continue to be an ongoing problem?

The issue of low Health Literacy

Health literacy—the ability to obtain, process, and understand basic health information and services to make appropriate health decisions—is essential to promote healthy people and communities.

This shows that only 12 percent of U.S. adults had proficient health literacy. More than a third of adults were in the basic (47 million) and below basic (30 million) health literacy groups. The majority of adults (53 percent) had intermediate health literacy skills.

How do we go about educating the whole population? Should it be the sole responsibility of the physician to educate patients? Is this even feasible? Would patients remember the physician’s explanations after their visit? Simply giving information and instructions from a position of authority without engaging patients have proven not to provide the desired result.

Health literacy and engagement are crucial if we want the patient to understand the benefits of adhering to their medication protocol. Despite its importance, few studies have specifically taken health literacy into account as a key part of any intervention program, by attempting to take low health literacy into account as a risk factor to be managed.

Improving medication adherence may require a coordinated effort of all stakeholders with the help of technology to support the patient journey

Technology-based interventions to improve medication adherence by tailoring educational information to individual patient needs, delivering technology-driven reminders to patients and providers, and integrating in-person interventions with electronic alerts could be the right approach to coordinate all stakeholders and improve patient adherence.

Different diseases need support at different stages of the disease progression — some earlier, some later, and some throughout the entire journey. For example, with chronic, progressive conditions that are treated with expensive biologic therapies, such as multiple sclerosis, patients require assistance with injection training, disease and symptom management, and emotional support. Patient support programs can add value by ensuring patients obtain access to the therapy, correctly use their therapy by watching relevant educational movies at the time of intake and continue to stay on therapy throughout all stages of their progression.

So, who should be responsible for a patient’s medication adherence? In my opinion, ALL stakeholders: Pharma and their Patient Support Programs (PSP), care providers, pharmacists, patients and family members — all connected via digital technology to follow the patient’s journey with the goal of improving coordination of care, better patient education, as well as inter-professional involvement in the follow-up of patients.