Today, medication non-adherence is one of the biggest drivers of poor medical outcomes and rising healthcare costs. While it may seem like a simple task to take medications as directed, an astounding 30 percent of prescriptions are never filled and 50 percent are not taken as prescribed.
While every situation is unique, many patients cite common barriers to non-adherence like knowledge gaps, a lack of time, inability to refill prescriptions, negative side effects, and more. However, as non-adherence is quickly becoming a growing epidemic across the country, many people don’t fully understand the repercussions of not following a prescribed treatment plan.
Recently, I hosted a webinar that addressed the issue of medication adherence, explaining why health plans should implement programs to encourage adherence through lasting behavior change. Following the presentation, I opened the floor, allowing attendees to ask questions on the topic.
I’ve included some of the top inquiries and my responses below.
- How do you define and measure medication adherence?
Medication adherence is a proportion (proportion of days covered or PDC), defined as the number of medication doses actually taken over a specific time period, compared to the total number of doses prescribed. A patient who falls above the 80 percent threshold has positive medication adherence and will therefore be at less of a risk for negative short- and long-term health repercussions.
- What is the most surprising commonly reported barrier or reason for non-adherence?
While there are a variety of reasons why people report not taking their prescriptions as directed, one of the most surprising is a lack of time and time management. While it’s expected that some people may find it difficult to get to a pharmacy to pick up their prescriptions on time, others note that they simply don’t have enough time in the day to physically take their medications or fit their medications into their daily routines – a somewhat shocking finding, as it can be a relatively quick process.This highlights the significant role that behavior and behavior change plays in medication adherence.
- What are some of the biggest challenges that you have with engaging patients regarding medication adherence, via phone specifically, and how do you overcome those challenges?
Any time an outside party attempts to contact patients over the phone, they face an uphill battle of not only getting people to answer the call, but also stay on long enough to have meaningful conversations. To overcome these challenges, we recommend health plans first notify patients to expect their call in the coming days through letters, emails, texts, or notifications in a company portal.Make these notifications as creative, pertinent, personalized and timely as possible for best results. Once on the phone, follow a series of techniques to enhance engagement, such as using friendly and relatable tones, asking patients about personal barriers, and listening actively to facilitate two-way conversations.
- What resources can health plans use for high-touch interventions, given the cost of pharmacist resources and the large number of populations?
One of the most effective methods health plans can employ to encourage better adherence is to connect and interact with patients through more than one channel (phone, email, mail, etc.). While this can be time-consuming, being strategic about who you target with which type of intervention will ensure time and effort is driving true ROI. To do this, we recommend that plans leverage predictive data and analytics to stratify your population and identify people at risk of non-adherence and who are most likely to be receptive to the selected intervention type (i.e. phone or email etc.). This will ensure organizations are not using valuable resources to connect with patients who aren’t at risk, are receptive to the first form of outreach, or are motivated to change recent behaviors.
- How can insurance plans, PBMs, etc. help to promote adherence considering that they may be unable to counsel patients directly (due to lack of pharmacist licensing across states)?
While medication non-adherence is inevitable among large populations, there are ways health plans can decrease the number of people missing doses or not filling prescriptions at all. Multi-channel outreach, population stratification, creative resource utilization, and enhanced training are all helpful to overcome the barrier of lack of pharmacist resources (due to cost, licensing etc.). If you’re interested in learning more about medication adherence programs and the most common barriers, watch my webinar today: