Let's Pay Attention to Medication Use in the Reform Debate

Janice Simmons, for HealthLeaders Media , August 27, 2009

While nonuse does not necessarily indicate misuse, this information does "indicate that something needs to looked into further" by providers when detecting noncompliance among patients, said Harry Leider, MD, chief medical officer of Ameritox, a company that performs urine screenings, and one of the study investigators.

In terms of population groups, the study confirmed previously reported findings that inappropriate use of prescribed medication spans all demographic groups, although in this study, men were significantly more likely to have an illicit drug detected than females.

In these instances, monitoring could be a "critical tool" that physicians could use in combination with "clinical expertise, intuition and their knowledge of each patient's history" to talk with patients about the proper use of medications and ultimately improve outcomes for patients with chronic pain, Leider said.

So where else to look when it comes to appropriate medication use and compliance? NEHI and analysts from Avalere Health interviewed experts and examined 34 adherence programs in the field. The interviews revealed that adherence can be improved using solutions that fall within three pillars:

  1. Improve drug regimen. This means following up with patients, making recommendations or changes when necessary, understanding patient preferences and experiences, and creating accurate medication use profiles.

  2. Reduce cost barriers. This calls for examining value based insurance design plans to lower employee contributions and out of pocket costs for cost-effective medications for chronic disease, identifying prescription assistance programs, and using generics.

  3. Address patient behavior. This calls for engaging patients in the care process, educating patients about their conditions and why they should take their medications, and addressing patient preferences, limitations, and priorities.

Janice Simmons is a senior editor and Washington, DC, correspondent for HealthLeaders Media Online. She can be reached at jsimmons@healthleadersmedia.com.

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