The Benefits of Medication Reminders for Non-Adherent and Non-Compliant Patients

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Medication adherence is the degree to which a patient follows a provider’s recommended medication treatment plan. Unfortunately, it is common to be medication non-adherent. It is also common to be medication non-compliant. This is when a patient deliberately and intentionally refuses medication. Both non-adherence and non-compliance are costly, consume health care resources, and contribute to poor health outcomes. Medications play a key role in treatment, which is why adherence and compliance is important. Medication reminders successfully contribute to patients becoming both adherent and compliant.

Medication Non-adherence

Medication non-adherence is when a patient unintentionally or intentionally refuses medication for reasons such as confusion, helplessness, or being overwhelmed. When patients practice some form of medication non-adherence, they are not getting the correct amount of medicine into their bodies at the right time. This can cause possible readmissions to the hospital, especially for people with chronic conditions. Once patients leave the hospital or doctor’s office, it is up to them to follow their medication regimen.

Non-adherence to the medication plan is often found in a patient who experiences the following:

  • Medication-related side effects
  • Belief that the medication is not working
  • Feeling better, belief that the medication is no longer needed
  • Cost of treatment
  • Lack of understanding
  • Lack of family support for medication taking

Medication Non-compliance

Medication non-compliance is the intentional choice to not take a medication according to the prescribed directions. There is a variety of reasons for this such as denial, depression, cultural issues, and questioning of a provider’s competence. Although medications are effective in combating disease, approximately 50% of patients do not take their medications as prescribed. While following instructions for your medications may seem simple, there are a lot of different factors that lead to medication non-compliance.

Non-compliance to a medication plan is often a result of these three factors:

  1. Patient-Related Factors: Inadequate health literacy is the main contributor. In the United States alone, an estimated 90 million adults have inadequate health literacy. Inadequate health literacy can lead to a lack of understanding their condition or medication instructions. To improve compliance, understanding the ‘why’ behind why patients do not take medications correctly and providing the appropriate education is an absolute necessity. The more a patient understands their condition and how to control it, the more likely they are to feel empowered and motivated to manage their disease and adhere to their medications.
  2. Physician- Related Factors: Physicians can often unintentionally lead to medication nonadherence by prescribing complex drug regimens, prescribing medications that may be unaffordable to the patient, or inadequately explaining possible side-effects a patient may experience. A solution to this is incorporating a pharmacist into the care team to provide medication education and spending more time with the patient when developing their care plan.
  3. Health System/Team Building Related Factors: Due to fragmented health systems, physicians do not have easy access to information from a patient’s numerous care providers. This can cause issues when developing an effect care strategy and communicating with a patient. Another factor in health systems that lead to non-compliance are drug costs, which can greatly limit a patient’s access to care. Increased implementation of electronic medical records and electronic prescribing has the potential to increase adherence by identifying patients at risk of nonadherence and targeting them for intervention.

Medication Reminder Apps

Traditional reminders like weekly pill boxes or packaged calendars are helpful for some patients but for others on more complex regiments, they just do not cut it. With electronic reminders it is easier to manage medications more efficiently. They are accessible, educate the patient, and provide a place for medication-specific information creating a more streamlined process.

There is a variety of free apps patients can download for little or no cost. Features of these apps include reminders for refills, medication information, drug discount codes, calendar-based alarms, and a place to log doses amongst others. These applications are a great strategy to incorporate as they aid patients and health care providers to improve medication-taking habits.

A study published in the Journal of Medical Internet Research showed that mobile apps help to improve medication adherence, even for adults who lack experience with smartphones. When patients struggle with adherence and compliance, incorporating and utilizing a mobile app will benefit them as they reach their health goals.

How Does Tria Health Help Prevent Non-Compliance and Non-Adherence?

Tria Health is a no cost benefit offered through select health plans. With Tria, you have the option of receiving a one-on-one private consultation with one of Tria Health’s pharmacists over the phone. During your consultation, your pharmacist will review all your current medications, including vitamins, supplements, and lifestyle habits. Your pharmacist will be able to identify any medication interactions, affordable substitutions and answer any other medication-related questions you may have. At the end of your consultation, you will receive a customized care plan that Tria will assist in coordinating with any of your physicians.

Sources:

  1. https://www.capphysicians.com/articles/noncompliant-vs-non-adherent-patient
  2. https://blog.cureatr.com/importance-of-medication-compliance-for-patient-safety
  3. http://www.bhevolution.org/public/medications.page
  4. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3919626/
  5. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3068890/

Driving Patients to Take an Active Role in Their Health Care

Katherine Meiners
Katherine Meiners, Director of Marketing & Communications

Central Exchange kicked off its 6 part Health Care Catalyst Series last week featuring consumer strategies related to having a healthy business. The presentation was led by Brent Walker, Chief Marketing Officer of C2B Solutions. Walker spent 20 years working for Proctor & Gamble prior to starting C2B Solutions.

The presentation focused on the importance of understanding psychographic segmentation in the health care consumer. C2B Solutions conducted a study that included a sample of 4,878 patients who completed a survey with 384 questions/attributes.

The study identified 5 different patient profiles:

  1. Balance Seekers (18%) – This group is proactive and wellness-oriented. They are open to many ideas, sources of information and treatment options when it comes to their healthcare.
  2. Willful Endurers (27%) – The highest population, this group takes a “don’t fix it if it’s not broken” approach to their health.
  3. Priority Jugglers (18%) – These individuals are busy taking care of others and are motivated by family verses by self.
  4. Self-Achievers (24%) – Highly motivated, this group focuses on future plans and is the most proactive when it comes to their wellness. They are task oriented and prefer to be given measurable goals.
  5. Direction Takers (13%) – The smallest population, these individuals like direction from providers and take it.

The varying differences in the patient profiles emphasize the need to communicate important health care messages differently. Traditionally, clinicians have been taught to speak to every patient as “direction takers.” With an increased focus on patient outcomes, clinicians need to learn how to better communicate with patients so they take an active role in their health care based on the different profiles. The benefit of the one-on-one counseling provided by Tria Health is our clinicians get an understanding of who the patient is and what motivates their medication behavior.

Find out what kind of patient you are by visiting C2Bsolutions.com.

Written by Katherine Meiners, Director of Marketing & Communications at Tria Health

The Secret to Saving Money on Your Health Care Costs

How many times have you left your physician’s office with a prescription that you never filled? Or stopped taking a prescribed medication because of side effects or high cost?

In some cases, not taking your medications as prescribed, referred to as non-adherence, may only cause minor health-related issues. However, when patients with chronic conditions such as diabetes, heart failure, high cholesterol and high blood pressure are non-adherent, they are putting their health at serious catastrophic risk.

Quick Glance at the Non-Adherence (Medication Mismanagement) Numbers:

–       3.9 billion prescriptions were written in 2010

–       On average, 50% of patients don’t take their medications as prescribed

–       Non-adherence costs the U.S. an estimated $317 billion annually

–       $106 billion of that total estimated cost accounts for non-adherence to medications for diabetes, high cholesterol and high blood pressure/heart disease

 

The Challenge:

One Patient + Multiple Conditions = Multiple Physicians & Multiple Medications

The average Tria Health patient sees four physicians and takes eight medications. As the number of medications increase, so does the level of patient-responsibility for daily management and understanding the purpose for each one. A major component of medication management includes patient communication with physicians about their drug regimen to prevent the risk of over-prescribing or taking medications that don’t interact well with one another.

What’s the solution?

Medication Therapy Management (MTM) is an innovative practice in which a pharmacist takes responsibility to optimize a patient’s medication regimen by ensuring medications are safe, appropriate and effective. Tria Health specializes in providing MTM services and partners with plan sponsors to help reduce over health care costs for them and their plan members. An MTM-focused pharmacist is able to work one-on-one with the patient and their physicians in order to ensure a complete circle of care.

For more information about Tria Health visit www.triahealth.com or call 1.888.799.TRIA (8742).

Sleep Smart to Improve Energy, Outlook and Productivity

Does it often take you more than 30 minutes to fall asleep at night? Or do you wake up frequently during the night — or too early in the morning — and have a hard time going back to sleep? When you awaken, do you feel groggy and lethargic? Do you feel drowsy during the day particularly during monotonous situations?  If you answered YES to any of these questions, you make be suffering from a sleeping issue, and you are not alone.

America is currently a sleep deprived country.  Overall sleep time is twenty percent less than a century ago!  The importance of sleep is vital and is not getting the attention that it deserves.

 The importance of sleep:

  • Restoration – energy to brain and body and allows for tissue growth and repair
  • Health – promotes healthy immune system, regulates hormones, growth, appetite, and mood
  • Memory consolidation

Sleep Stats:

  • 36% Americans drive drowsy/fall asleep – it is estimated that >100,000 auto crashes annually occur resulting in 1500 deaths.
  • 29% drowsy or fall asleep at work
  • 20% have lost interest in intimacy
  • 14% have missed social/family functions due to excessive fatigue

Sleep Quantity and Quality

Sleep quality refers to sleep efficiency. TIME IN BED=TIME SLEEPING!!

Frequent interruptions can lead to loss of important sleep stages.  Insomnia can result from medical or lifestyle/environmental contributors.  Medical insomnia often refers to sleep apnea, narcolepsy or restless leg syndrome (RLS).  Lifestyle/ environmental insomnia typical results from “sleep stealers.”

How much sleep is enough?

Age Sleep Needs
Newborns (1-2mon) 10.5-18 hours
Infants (3-11 mon) 9-12 hour nights and 4 naps/day
Toddlers (1-3yr) 12-14 hours
Children (3-5 yr) 11-13 hours
Children (5-12 yr) 10-11 hours
Teens 8.5-9.25 hours
Adults 7-9 hours
Older adults 7-9 hours

Common Sleep Stealers

  • Psychological – stress in the number one cause of short-term insomnia
  • Lifestyle Stressors – irregular sleep/exercise schedule, alcohol, caffeine
  • Shift work
  • Jet lag
  • Environment – temperature, light, noise, children/spouse, pets
  • Medical

Analyzing YOUR sleep habits

Look at your individual sleep patterns and behaviors.  Keeping a sleep diary is a great way to document your sleep quality and quantity.  It will also help you identify “sleep stealers.”

  • Identify fatigue level
  • Trouble staying awake during monotonous activities?
  • Unusually irritable??
  • Difficulty concentrating or remembering facts?

Small changes YOU can make- Non-pharmacological Treatments and Solutions

  • Maintain regular sleep schedules – avoid “sleeping in” on weekends.  Daily sunlight exposure is important as well
  • Avoid post lunch caffeine
  • Avoid nicotine and alcohol within 2 hours of bedtime
  • Exercise regularly and earlier in the day – goal 30 minutes most days of the week preferably late afternoon (4-6 hrs before bed- this allows your body to cool down before bed)
  • Save bedroom for sleep and intimacy ONLY
  • Relax/unwind before bed- try to keep T.V., computers and smart phones out of the bedroom
  • Avoid daytime napping
  • Control bedroom temperature- a cool environment is usually best
  • Don’t lie in bed awake- if unable to fall asleep within 10 minutes, get out of bed and do something relaxing like reading or listening to soft music until drowsy
  • Stay up later? Make gradual changes to schedule to improve sleep efficiency

Tria Health Circle of CareVisit Triahealth.com or call our Tria Help Desk at 1.888.799.TRIA (8742) for more information.

 

10 Self-Care Strategies for Diabetes

1. A1C:

A1C is a test that doctors use to measure your average blood sugar control for the past 2-3 months. Your goal should be an A1C of less than 7%. Have your doctor check your A1C at least twice a year, or more frequently if your blood sugar is not well controlled.

2. Blood Glucose Monitoring:

Checking your blood sugars will let you know how well your diet and medications are working. It is normal for your blood sugars to rise and fall throughout the day, so it is important to talk with your doctor about when to check your blood sugars. Blood Glucose Targets: Fasting or before meals – 70-130 mg/dl; two hours after the start of a meal or snack – less than 180 mg/dl.

3. Blood Pressure:

The combination of high blood pressure and diabetes can put you at higher risks for heart disease, kidney disease and stroke. Remember to take your blood pressure pills daily. Try to keep your blood pressure lower than 130/80 mmHg.

4. Cholesterol:

Keeping your cholesterol in check can help lower your risks of heart disease and stroke. Have your doctor check your cholesterol routinely. For more accurate cholesterol test results, avoid eating for 8 hours before you have your blood drawn.

5. Quit Smoking:

Quitting smoking greatly decreases your risk of heart attacks, strokes, and other health problems. Talk to your doctor or pharmacist about the products available to help you quit smoking. Over the counter medications include nicotine chewing gum, lozenges or patches. Prescription options include: Buproprion SR (Zyban®), Varenicline (Chantix®), and nicotine inhaler or nasal spray.

6. Daily Foot Exams:

Check your feet daily for cuts, infections, sores, and make sure toenails are trimmed and kept clean routinely. If you notice any cuts, discolored skin, rashes, or sores that do not go away after 3-5 days, please notify your doctor.

7. Diet/Exercise:

Simple changes like these can help you live a healthier life with diabetes – Exercising 30-45 minutes three to four times a week; limiting alcohol intake to 1-2 drinks per day; reading the nutritional labels on food products to help monitor your intake of sodium and fat.

8. Hypoglycemia:

When your blood sugar is too low, you may experience dizziness, sweating, trembling, fast heartbeat, and wet clammy fingers. Treat these symptoms of hypoglycemia with the “Rule of 15’s.”

  • Eat 15 grams of carbs (i.e. ½ cup orange juice or non-diet soda, 1 tablespoon honey, syrup or sugar, 6 to 10 lifesavers, 1 glass of milk)
  • Wait 15 minutes, then recheck your blood sugar
  • If you’re blood sugar is still low, eat another 15 grams of carbs and repeat step #2
  • If your blood sugar is still low after repeating steps 1 through 3 twice, call your doctor or 911
9. Regular Check-ups & Immunizations:

  • Comprehensive dilated eye exam annually
  • Dental exams every 6 months
  • Monofilament foot exam yearly to check for nerve damage or diabetic neuropathy
  • Flu shots yearly
  • Pneumonia vaccine once if less than 65 years old; Repeat vaccine if greater than 64 years old and  if first vaccine was given more than 5 years ago
10. Medication Adherence:

Medications play an important role in your health and they work best when they are taken correctly.  If you don’t take your medications as recommended by your doctor or pharmacist, they will not work as well as they should. It is important to follow the directions for each medication so you’ll get the most from them and stay in better health.

Visit Triahealth.com or call our Tria Help Desk at 1.888.799.TRIA (8742) for more information.