It is estimated that between one third and a half of patients incorrectly take their medications, and the costs incurred amount to 13% of the total health expenditure.
The report, Thinking Outside the Pillbox: A System-wide Approach to Improving Patient Medication Adherence for Chronic Disease, also found that it is patients with chronic illnesses, such as diabetes or high blood pressure, who are less likely to take their medications as intended, than those being treated for an urgent problem.
The study attributes the mistakes to high costs, unpleasant side effects, confusing regimes, forgetfulness and other patient behaviours, such as feeling too good to need medication. It outlines four solutions which could reduce the problem:
- Creating healthcare teams - incorporating nurses, pharmacists and other clinicians in supporting medication adherence;
- Patient engagement and education - involving primary care providers and pharmacists to ensure patients know the importance of taking their medication properly;
- Payment reform - changing reimbursement incentives away from rewarding volume and towards rewarding good patient outcomes, which would encourage providers to invest in resources, such as counselling services, to improve medication adherence; and
- Leveraging health information technologies - using technology such as e-health records and e-prescribing, to give providers secure knowledge of the patient’s current medications and when prescriptions are due to be refilled.
Further reading - A detailed analysis of the US pharmaceutical market is available from Espicom: The Pharmaceutical Market: USA (published June 2009)