Medication Compliance – What’s the Problem?

Pills in plastic case
Image Source: Simon van der Koelen/Unsplash

Medication non-compliance is the failure to take a medication according to the prescribed directions. Although medications are effective in combating disease, approximately 50% of patients do not take their medications as prescribed. Poor adherence to medication leads to increased morbidity and death and is estimated to incur costs of approximately $100 billion per year.1 While following instructions for your medications may seem simple, there are a lot of different factors that lead to medication compliance.

What Causes Non-Compliance?

Non-compliance factors can be broken down into three categories: Patient-related, physician-related and health system/team building-related.

Patient-Related Factors:

While there are several patient-related factors, the main contributor to medication non-compliance is inadequate health literacy. In the United States alone, an estimated 90 million adults have inadequate health literacy.1 Inadequate health literacy can lead to a lack of understanding their condition or medication instructions. In order to improve compliance, understanding the ‘why’ behind why patients don’t take medications correctly and providing the appropriate education is an absolute necessity. These reasons are very individualized and the more a patient understands their condition and how to control it, the more likely they are to feel impowered and motivated to manage their disease and adhere to their medications.

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.

Health System/Team Building-Related Factors:

Unfortunately, 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. Another solution can be the incorporation of a medication therapy management service, which can help identify instances of nonadherence and possible substitutions for costly medications.

How Does Tria Health Help Prevent Non-Compliance?

Tria Health is offered through your benefits plan. 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’ll receive a customized care plan that Tria will assist in coordinating with any of your physicians.



Study shows medication adherence improves through health coaching

Working one-on-one with a medical professional may improve the rate at which chronic condition patients take their medications correctly, according to a study published earlier this month in the Journal of the American Board of Family Medicine. After participating in health coaching for a year, medication rates among patients with type 2 diabetes, high blood pressure or high cholesterol had increased.

The study looked at patients between the ages of 18 and 75 who had uncontrolled Type 2 Diabetes, high blood pressure or high cholesterol. The patients were split into two groups, the first receiving health coaching for 12 months and the second continuing with their normal care. At the end of the year, adherence reported by the health coaching group had improved significantly while adherence reported by the usual care group did not improve, and in some cases, worsened by the end of the study.

Patients who participated in the health coaching reporting reported a 23 percent increase in the number of patients who reported taking their medications exactly as prescribed for at least five of the last seven days. The group that had continued with their usual care reported a 5 percent decrease.

Increased patient knowledge, patient counseling and active patient participation are already known to improve medication adherence. Health coaches may have more time to spend with patients, and this may have impacted the participants’ engagement with their treatment and influenced their medication adherence. The health coaches also worked with patients on healthy lifestyle changes, which also may have impacted change.

The study cites statistics about the high cost to the U.S. healthcare system caused by medication nonadherence. About half of medications prescribed for chronic conditions aren’t used correctly, which contributes to more than $200 billion in avoidable costs to the health care system each year.

For more information about how Tria Health works to improve medication adherence among our patients, visit our website.