3 reasons why patients do not take their meds as prescribed
By Priya Komarlingam, Founder and CEO.
USD 300 billion annually.
This is the cost to our healthcare system from Americans not taking their medications as prescribed, or medication nonadherence as it is commonly known.
Medication nonadherence rates in the United States is a high 50% among people with chronic conditions and is responsible for over 125,000 deaths annually. This means diseases then progress at a faster rate, the rate of preventable hospitalizations rises, and complexities increase.
These facts are what is drives payors – hospitals, insurance providers and large corporate employers – to focus on value-based healthcare delivery. Payors are implementing various methods to incentivize, motivate and track patient compliance with their doctor’s orders for better overall health and preventive care.
The first step to lowering medication non-compliance rates is to understand why they are so high in the first place?
Here are the top 3 reasons why patients do not take their medications as prescribed.
High cost of medication
The high cost of drugs is the top reason for medication non-compliance. Particularly for people suffering from one or more chronic conditions, out-of-pocket costs for required medication can be daunting. A recent national poll conducted by CVS Health discovered that 83% of Americans were very concerned about rising drug prices.
Many insurers or employer plans use higher deductibles to offset insurance costs, which can then lead to higher out-of-pocket costs for individuals suffering from chronic conditions. Patients with higher co-pays are less likely to fill their prescriptions. Unfortunately, this then leads to a deterioration in health.
Legislators, employers, and insurance providers are working to push back on rising drug costs in different ways. 24 states in 2018 passed bills to increase transparency around drug manufacturers’ pricing and reduce reliance on pharmacy benefit managers who act as middlemen between pharmacies and drug manufacturers.
Corporations providing employee health benefits are also beginning to incentivize their employees to embrace healthier lifestyles by redesigning health benefit options and removing the burden of co-pays for chronic illnesses. Why do employers care?
Over 60% of Americans under 65 years are insured through their employers. By conducting bulk negotiations with insurance companies for employees with chronic illnesses, employers gain leverage to drive down costs. Apart from health premium costs, employee medication non-adherence also affects productivity if health conditions deteriorate – which could then lead to further disruptions to workflow.
Insurance plays a considerable role in whether patients take their medicines or not. People are more likely to be non-compliant with their prescriptions when they have to pay more. Insurance companies face the challenge of balancing high drug costs and managing their customers’ premiums. Medication adherence is beneficial to insurance companies because it is more economical for them to incentivize people to take medications than shoulder critical and expensive hospitalizations down the line.
Misunderstand disease conditions
In the United States, patients only have an average of 16.5 minutes of face-to-face interactions with their primary care physicians. This is not enough time for the doctor to evaluate the patient, understand their symptoms, provide a diagnosis and educate them about their conditions in great detail. Overworked healthcare workers also cannot devote too much time to following up with individual patients and ensuring they are on track with their medication, diets, exercise, and appointments.
Adequate education and constant motivation for patients play a vital role in managing health outcomes. This is why healthcare providers and other payors are turning to health assistants or coaches (virtual or in-person) to help with medication adherence, counselling, coaching and motivating patients to take better care of themselves.
If patients do not receive adequate education, they often misunderstand their disease conditions. In particular, many patients suffering from chronic conditions ignore the importance of taking medication and following their diets regularly. Instead, several of them end up managing their symptoms when they flare up but are otherwise not as vigilant in being regular with their medications, diets and doctor appointments. ‘Silent’ and mostly symptom-less conditions like high blood pressure, high cholesterol or even mental health issues like depression, anxiety, and require regular healthy habits even when patients don’t “feel” any adverse effects.
Another issue with limited patient education is that people don’t always know how to manage their body’s response to their medication. With regular health mentoring, healthcare providers can monitor symptoms, key health metrics and provide timely intervention and assistance when required.
Difficulty in managing changes in routines
There’s a reason why the self-help industry in the United States is expected to be worth a whopping USD 13.2 billion by 2022. We are well aware that we need to eat well, exercise moderately every day, get enough sleep and take care of our health. The reality, however, is different. Knowing something is not equal to achieving it. Many of us strive to do better and create better habits for ourselves and need coaching and motivation to accomplish this.
Getting a diagnosis at a doctor’s office, particularly for one or more chronic conditions can potentially mean changing several well-ingrained habits for our health. Developing better health routines is less about willpower or good intentions and more about tweaking our daily habits to incorporate newer ones.
For busy people, it can be challenging to remember to take medications or get refills while juggling work, kids, caregiving and everything else on their plates at the same time. Many caregivers, exhausted from the demands of taking care of someone else’s ailments, put their own medical needs on the back-burner. People suffering from one or more chronic conditions find it hard to get their prescriptions organized, and may end up taking their pills mostly when in pain from symptom flare-ups. Busy executives always on the move find it challenging to find convenient solutions to help them manage their conditions while meeting their job requirements.
Daily trackers, reminders, alerts, and milestones play an essential role in motivating people to take their prescriptions. Together with sustained health mentoring from qualified experts, there is an excellent opportunity to lower medication nonadherence rates. However, alerts sent through phone messages or complicated apps have not proven to improve medication adherence rates and the need for smarter and more intelligent Health mentor technology is required for a comprehensive patient support system to be built in and out of the hospital system.
Healthcare and insurance providers realize the power of effectively motivating their patients at regular intervals and are partnering with wellness companies that offer health coaching and mentoring technology. Employers provide health checks, financial and group fitness incentives for their employees. Cutting-edge smart technology is being developed every day based on the psychology of habit formation and help people take better care of themselves every day.
These are the top three reasons why people do not take their medication as prescribed in this country. The healthcare industry currently faces resource constraints, healthcare worker burnout, and is overburned. Leveraging cutting-edge smart technology can help healthcare providers deliver value-based care and help patients get healthy.
CueMed is passionate about helping people build better health through better habits. We are proud to introduce HEXIS – an intelligent health mentor and assistant that provides 360° support to people trying to juggle their daily busy lives and their chronic illnesses.