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No Silver Bullet for Medication Adherence

Margaret Dick Tocknell, for HealthLeaders Media, July 3, 2013

Cost and forgetfulness play a large role in non-adherence, but even when medications are supplied at no cost, adherence hovers around only 50%. Forging personal connections with pharmacy staff can help, one insurer says.

A "spoonful of sugar helps the medicine go down," Mary Poppins, the quintessentially perky nanny,explains in song and dance to her young charges.

If only it were that simple to get patient to follow prescription orders.

A report card [PDF] released last week by the National Community Pharmacists Association places medication adherence for individuals with chronic conditions at the C+ level, with one in seven receiving a failing report card grade.

Skipping medicine doses and failing to get prescription refills are among the patient behaviors that threaten patient health, especially among individuals with chronic conditions. The NCPA report estimates that medication non-adherence adds about $290 billion to healthcare costs each year.

There is no shortage of interest among industry stakeholders in resolving this issue, especially as the delivery of healthcare services becomes more interdependent and accountability for patient outcomes extends all along the care continuum. A breakdown anywhere along that path can take money out of everyone's pocket.

Unfortunately, there is no one-size-fits-all solution to medication non-adherence. That's mostly because there's "not just one thing that keeps a group of patients or even one patient from taking their medications as prescribed," says Edmund Pazella, MD, national medical director for pharmacy policy and strategy for the Hartford, CT-based insurer, Aetna.

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