Medication adherence usually refers to whether patients take their medications as prescribed (eg, twice daily), as well as whether they continue to take a prescribed medication.Adherence has been defined as the “active, voluntary, and collaborative involvement of the patient in a mutually acceptable course of behavior to produce a therapeutic result.”
Drug companies around the globe are spending big to push patients to take their pills. The pharma industry loses tens of billions in worldwide sales each year when patients don’t fill, or refill, their prescriptions. So drug makers across the globe are pouring money into programs aimed at helping patients to take every last pill their doctors prescribe.
This definition implies that the patient has a choice and that both patients and providers mutually establish treatment goals and the medical regimen.
Medication adherence behavior has thus been divided into 2 main concepts, namely, adherence and persistence.
Medication non-adherence, either willful or inadvertent, can include:
- Failing to initially fill a prescription
- Failing to refill a prescription as directed
- Omitting a dose or doses
- Taking more of a medication than prescribed
- Prematurely discontinuing medication
- Taking a dose at the wrong time
- Taking a medication prescribed for someone else
- Taking a dose with prohibited foods, liquids, and other medications
- Taking outdated medications
- Taking damaged medications
- Storing medications improperly
- Improperly using medication administration devices (e.g., inhalers).
“Drugs don’t work in patients who don’t take them.” —C. Everett Koop, MD
But why is medication non-adherence such a major concern and why it is so important ? Medication non-adherence is a growing concern to clinicians, healthcare systems, and other stakeholders (eg. tax-payers, pharma manufacturers) because of mounting evidence that it is prevalent and associated with adverse outcomes and higher costs of care.
Poor medication adherence is responsible for avoidable hospital admissions, and 33 to 69 percent of all medication-related hospital admissions in the U.S., at a cost of about $100 billion per year.Non-adherence to medication regimens also affects the quality and length of life; for example, it has been estimated that better adherence to anti-hypertensive treatment alone could prevent 89,000 premature deaths in the United States annually.
Some key stats on Medication Adherence32 million Americans use three or more medicines daily
- 75% of adults are non-adherent in one or more ways
- The economic impact of non-adherence is estimated to cost $100 billion annually
The average adherence rate for medicines taken only once daily is nearly 80 percent, compared to about 50 percent for treatments that must be taken 4 times a day. As many as 75 percent of patients (and 50 percent of chronically ill patients) fail to adhere to, or comply with physician prescribed treatment regimens.
Studies have shown than non-compliance causes 125,000 deaths annually in the US , leads to 10 to 25 percent of hospital and nursing home admissions, and is becoming an international epidemic.It is, in the words of The New York Times the world’s “other drug problem”.
Negative Economic Effects of Non-Compliance
· 23% of nursing home admissions due to noncompliance. Cost $31.3 billion / 380,000 patients.
· 10% of hospital admissions due to noncompliance. Cost $15.2 billion / 3.5 million patients.
· About 50% of the 2 billion prescriptions filled each year are not taken correctly .
· 1/3 of patients take all their medicine, 1/3 take some, 1/3 don’t take any at all (Rx prescription never filled) .
· 25,000,000 nonprofessional caregivers in the US .
· 80% of nonprofessional caregivers are women .
· 80%-90% of people requiring care in the US receive it from family members or friends .