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Report Finds Improving Medication Compliance Reduces Cost, Improves Outcomes

September 25, 2018

The National Council for Behavioral Health’s Medical Director Institute has released a report estimating that half of people on any medication fail to take it as prescribed.

“Medication Matters, Causes and Solutions to Medication Non-Adherence” reports that many patients who are prescribed medications fail to take them appropriately or they do not take them at all. Changing this pattern could lead to cost savings and better care management.

For the purposes of the study, adherence or compliance with a medication plan is defined as the extent to which patients take medications as prescribed by their health care providers. The authors found that when surveying literature related to medication adherence, non-adherence is a major problem across all health care delivery systems and settings.

The report stresses that for people with chronic medical illnesses, this behavior can significantly add to disease burden and poorer long-term health outcomes. Adherence to pharmacotherapy also is a critical element in effective treatment of mental disorders as well.

The authors say medication non-adherence has become a significant barrier to achieving the Institute for Healthcare Improvement’s Triple Aim, which calls for:

  • Improving the patient’s experience of care
  • Improving the health of the population
  • Improving the provider experience and reducing per-capita costs of health care

The institute recommended a series of solutions to ensure patients are using drugs correctly. The report suggests that if a “substantial” number of the ideas were adopted by 2025, the country could achieve $2 billion in annual savings from reduced hospital costs alone. Solutions include: 

  • Better communication between physicians and patients
  • Increased use of risk assessment to determine patients least likely to take medications correctly
  • Greater use of long-lasting injectables over medications taken at home
  • Increased patient access to pharmacy services
  • Enhanced data sharing to flag instances of non-adherence

Improved communication stands out as a key solution, but also one that is hard to achieve. Patients often are uncomfortable expressing their concerns about their medications or they do not admit that they have stopped taking them.

The report states that “implementation of multiple interventions by multiple stakeholders, applied over time and with consistent follow-through, will be necessary to make substantial improvements on medication adherence.”  Authors stress information exchange connectivity and payment methodologies as critical.

Better communication, medication adherence champions, improved health and mental health literacy, and core competencies for motivational interviewing and shared decision-making, are identified as foundations for patient engagement and treatment.

HAP’s quality and patient safety work and its involvement with patient and family engagement provide ongoing opportunities to reaffirm many of the best practices in the report.

The National Council for Behavioral Health (National Council) is the largest organization of mental health and addictions treatment programs in the U.S., serving 10 million adults, children, and families with mental health and substance use disorders (SUDs).

To learn more about HAP’s quality and patient safety work, contact Robert Shipp, HAP’s vice president, population health strategies. To learn more about HAP’s patient and family engagement work, contact Janette Bisbee, HAP project manager.

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