A Simple Way to Foster Medication Adherence

Medication non-compliance causes nearly 125,000 deaths in the United States and costs an estimated $290 billion annually. In fact, the number of patients who are non-compliant has reached epidemic proportions and is increasingly considered to be one of the most pressing issues in healthcare today. Research from the National Council for Patient Information and Education suggests that roughly 50% of patient prescriptions are taken incorrectly or not at all.

One survey found that a third of patients discharged, did not understand the purpose of their medications when they went home, and 86% of patients did not know their medications side effects. Consequently, there has been a breakdown between the communication of medication instructions and what patients are comprehending.

Patient adherence to a medication regimen is critical to good patient outcomes. Effective provider/patient communication is also critical to positive outcomes, patient satisfaction, health status, and adherence. According to the Agency for Healthcare Research and Quality, educating patients before they leave the hospital can decrease readmissions, reduce unnecessary visits to the ER, and lower costs.

Although medication adherence is a complex issue, research suggests that simple interventions are the most effective in fostering medication adherence. The American College of Preventative Medicine recommends using the mnemonic SIMPLE, to help improve patient adherence.

• S imple regimen
• I mpart knowledge
• M odify patient beliefs and human behavior
• P rovide communication and trust
• L eave the bias
• E valuate adherence

S – Simple regimen. A complex treatment can affect patient compliance. Which is why providers should consider trying a simple regimen whenever possible. Medications taken once-a-day, or at the same time of day are usually preferred. However, the regimen should also coincide with the patient’s daily activities. Encourage the use of aids such as medication organizers and alarms.

I – Impart knowledge. Adherence is increased when patients are knowledgeable about their conditions and the benefits of treatment. A few best practices include:

• Focus on shared decision-making.
• Provide clear, written, and verbal instructions for all prescriptions.
• Speak in common terms and try not to use medical jargon.
• Include the use of written information or materials.
• Include family and friends when appropriate.
• Offer quality online references for patients that wish to seek health information from the web.

M – Modify patient beliefs and human behavior. Patient education alone is not enough to improve patient adherence. Engaging patients in an open dialogue about their expectations is also necessary.  Address any fears or concerns the patient may have about taking the medication. Empower patients to self-manage their condition and ensure they are clear about the risks of non-compliance.

P – Provide communication and trust. A physician’s communication style is one of the key factors to winning patients trust. Best practices for enhancing communication include:

• Improve interviewing skills
• Practice active listening skills
• Provide emotional support
• Provide clear, direct, and thorough information
• Encourage the patient’s input in treatment decision-making
• Allow time for patients to ask questions ‘
• Build trust

L – Leave the bias. Physician interventions that increase patient/physician partnership are important strategies to overcome disparities. For example:

• Encourage practice to learn more about low health literacy and how it affects patient outcomes
• Review communication style to see if it is patient-centered
• Understand the demographics of a patient population
• Ensure patient communication and education is tailored to the patient’s level of understanding

E – Evaluating adherence. The problem of nonadherence is often underestimated. However, if it isn’t suspected, it cannot be corrected. Measuring adherence can lead to better patient compliance and can be implemented through self-reports and simply asking patients directly if they are following their drug regimen.

References :

• http://www.epill.com/statistics.htm
• https://www.medscape.com/viewarticle/818850
• http://catalyst.nejm.org/optimize-patients-medication-adherence/
• https://cdn.ymaws.com/www.acpm.org/resource/resmgr/timetools-files/adherencepatientguide.pdf
• https://alwaysculture.com/hcahps/communication-medications-effects-hcahps-scores-patient-safety/
• https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1681370/