One of the biggest issues facing public health today is medication adherence. With greater access to healthcare, a vast majority of patients remain non-compliant with taking their medication. A 2013 report by the National Association of Community Pharmacists determined that the average score for medical compliance was a C+.
When you consider that medications are prescribed to improve an individual’s health; the question becomes, why would a patient not be compliant?
Some of the many factors influencing medical compliance are listed below:
It should be noted that the cost of non-compliance affects not just the patient but public health in general. In 2012, Brian Fung wrote about, “the $289 billion cost of medication compliance, and what to do about it”. In this article, the author explores how expensive it is for the public and healthcare at large when individuals do not take their prescribed medication. A simple example is the person who does not take his/her blood pressure medication, then suffers a stroke. The cost of hospitalization alone is phenomenal, as this person would potentially be expected to be seen in the ER, ICU, and require emergency medications, surgery, Physical Therapy, as well as Speech and Occupational therapy for extended periods of time. Additionally, some people who suffer a stroke may never recover. These individuals may need extended care at home, as well as remote monitoring devices. In some cases, individuals are not able to live independently and need to be placed in assisted living facilities. Even in the best case scenario carries a hefty price tag; which the patient may or may not be able to afford. This cost inadvertently is transferred to the public by way of increased taxes, and/or higher insurance deductibles.
This issue, along with specific causes of the issue has been identified and is being studied by various sectors of the healthcare industry including primary care providers, pharmacists, nurses, and even social workers/case managers. It has been acknowledged that enhanced involvement with health care professionals can improve patient’s medical compliance. Brian Fung cites the use of case management and coordinated care to enhance compliance.
Case management and coordinated care is a very demanding area of health care that can be very time consuming especially due to communication. As technology has evolved over the last few years, advances in communication have improved the field of telemedicine, which is being noticed as an excellent tool for coordinating patient care.
Telemedicine allows the healthcare provider (doctor, nurse, pharmacist case manager/social worker) to contact the patient telephonically while using computers, mobile phones, and applications to provide the necessary education regarding medication. Using this type of tool allows the healthcare provider to consult with the patient outside of office hours and at a time that works for both patient and provider. In many instances, the person providing the education has both the time and resources to answer questions and be able to impart the importance of medication adherence.
Education is a large part of medication adherence. Taking the time to explain and ensure patients understand why using their medication is important, improves the likelihood that they will be compliant.
Care managers and/or providers who utilize telemedicine and technology can guide their patients by having them engage in behaviors that increase their usage of their medications. Providers and patients can leverage technology to ensure patients are taking their medication using tracking programs, and providing reports back to their healthcare provider on their usage as well as their lab results (ex: blood pressure/blood sugar), and symptoms that they experienced.
Telemedicine is unique as it allows healthcare to be more accessible to patients. This tool allows providers to reach patients across great distances, decreasing the time a patient needs to travel to and from the provider’s office. It does allow a provider to reach a patient that may be homebound, making monitoring of that patient as well as their compliance quite easy.
There is the advantage that communications can be inclusive of caregivers who may not have been able to attend an office visit but who provide care to a patient, and need to be aware of their treatment plan.
It should be noted that when patients see the overall improvement in their health, they are likely to remain committed to taking their medication as prescribed by the provider. While there are additional factors that may prevent medication adherence, the use of telemedicine is likely to have the greatest impact on compliance and could likely lead to cost savings in more ways than one.