Nonadherence to medications is a universal issue that has garnered significant attention in recent years. However, a new study concluded that medication nonadherence represents only a fraction of medication-related problems experience by patients.
Nonadherence to medications is a universal issue that has garnered significant attention in recent years. It has been linked to poor health outcomes, increased hospitalizations, and even death—all of which cost the US healthcare system billions of dollars.
However, a new study published in the Journal of Managed Care & Specialty Pharmacy concluded that medication nonadherence represents only a fraction of medication-related problems (MRPs) experienced by patients. The study, led by Todd D. Sorenson, PharmD, insists that healthcare needs to expand its narrow focus on adherence as a problem to MRPs. By focusing just on that will limit the ability to control morbidity and mortality associated with nonoptimal medication use.
The study attempts to review the focus of medication nonadherence in the literature by outlining a broader framework for MRPs, and identifying the rates of medication nonadherent through a comprehensive medication management (CMM) care model.
Triple Aim Not Solely Dependent on Medical Adherence
Medication adherence is one of the leading problems (third most frequent type of MRP) in better healthcare. Nonadherence could mean requiring a medication that has not been prescribed, or receiving a low-dosage prescription not enough to show results, or a patient discontinuing a medication because of adverse effects.
Success in achieving the triple aim of healthcare (improved health, better care experience, and reduced per capita costs) is highly dependent on optimizing medication use. However, the study insists on expanding the lens to study beyond medical non-adherence.
“Although medication adherence has been studied through many lenses, including specific disease states, patient populations, behavioral factors, and economic factors, what is lacking in the literature is a comprehensive analysis of the degree to which nonadherence is a problem in comparison to other types of problems associated with medication use,” noted Sorenson.
The researchers agree that poor outcomes or avoidable costs are deemed to be a result of nonadherence alone. But that is only a part of the problem.
Moving Beyond Medical Non-Adherence
To understand the scope of nonadherence when CMM services are used, the researchers studied the frequency of MRPs in patients within the Fairview Health System from January 1, 2013, through December 31, 2014, across 7 categories. The study found that 40% of patients had an MRP associated with medication nonadherence.
But more important was the finding that the remaining 60% experienced problems that were not related to medication adherence. The most common MRPs experienced by patients were “dose too low” and “needs additional drug therapy.”
If healthcare policy continues to emphasize solely on adherence as a marker of appropriate medication use, then it will not fully achieve the promise of the triple aim.
“The majority of MRPs are not related to adherence,” the study noted. “If left unresolved, they can obstruct achievement of desired health outcomes and cost savings associated with well-managed chronic illness.”
Overcoming Employment Barriers for Lasting Social Impact: Freedom House 2.0 and Pathways to Work
April 16th 2024To help celebrate and recognize National Minority Health Month, we are bringing you a special month-long podcast series with our Strategic Alliance Partner, UPMC Health Plan. Welcome to our second episode, in which we learn all about Freedom House 2.0 and the Pathways to Work program.
Listen
An Overview of Health Care and Pharmaceutical Trends, 2023-2024
April 19th 2024Douglas M. Long, BA, MBA, was featured as the keynote speaker on the closing day of The Academy of Managed Care Pharmacy 2024 annual meeting, with a session dedicated to surveying the health care and pharmaceutical trends of the last year.
Read More
Making Giant Strides in Maternity Health Through Baby Steps
April 9th 2024To help celebrate and recognize National Minority Health Month, we are kicking off a special month-long podcast series with our strategic alliance partner, UPMC Health Plan. Welcome to our first episode, which is all about the Baby Steps Maternity Program and its mission to support women throughout every step of their pregnancy journey.
Listen
Government agencies have created an online portal for the public to report potential anticompetitive practices in health care; there are changes coming to the “boxed warning” section for chimeric antigen receptor T-cell therapies (CAR T) to highlight T-cell blood cancer risk; questions about the safety of obesity medications during pregnancy have arisen in women on them who previously struggled with fertility issues.
Read More