Three steps to improving medication adherence, reducing costly hospital stays

Up to half of all patients fail to take their medications faithfully as prescribed, compromising their health and costing the healthcare system $100 billion in preventable hospital stays per year, revealed a study in the April 29 New England Journal of Medicine. And as the reasons for poor medication adherence range widely, from financial concerns to lack of symptoms to overly complicated regimes, hospitals and the healthcare system must implement an array of solutions, reports the Boston Globe.

For starters, many patients require more help understanding doctor's orders than they currently receive. "If you're faced with trying to take 10 different types of medicines at various times of the day, if you're going to get it right, it's going to take an awful lot of organization and support,'' said Dr. Thad Schilling, an internist at Harvard Vanguard Medical Associates.

And the need for patient education becomes even more critical involving drugs, many of which have side effects, that don't address symptoms that patients experience directly, such as those to control blood pressure or cholesterol. "If I don't have any symptoms and my doctor says, 'Please take this drug to keep your blood pressure lower,' and the drug itself makes me feel tired or not myself, then I have a little internal battle going on,'' said Wendy Everett, president of New England Healthcare Institute, a think tank underwritten by foundations and corporations.

Finally, providers must acknowledge the role of finances in patient behavior. For example, a study last year showed that a $5 increase in copayments for cholesterol-controlling statin drugs significantly reduced the likelihood prescriptions would be filled by veterans in Philadelphia (though some with zero copayments still failed to get their medications). For some seniors, the strain to pay for medications may be alleviated on June 15 when they receive $250 to help fill the "doughnut hole" in Medicare's pharmaceutical benefits.

To learn more:
- read this Boston Globe article
- check out this Associated Press piece
- here's the NEJM abstract

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