Medication Non-Adherence: The Hidden Epidemic Managing Medication Adherence & A Safe Hospital Discharge David R Donohue, M.A., Qualitative Technologies, Inc. Milwaukee, WI Dr. Tom Muscarello, Ph D, DePaul University, Chicago, IL
50% of the 3.6 billion prescription medications dispensed annually in the United States are not taken
correctly by patients
Henry J Kaiser Family Foundation, 2009
U.S. Patients Do Not Take Medications as Prescribed American Heart Association: Statistics you need to know. http://18.104.22.168/CAP/pro/prof_statistics2.html . Accessed July 27, 2009. 100% 76%* 88% 47%* Rx prescribed Rx continued Rx taken Rx filled -12% -12% -29% * 22% of U.S. patients take less of the medication than is prescribed
Impact of Medication Adherence on Hospitalization Risk *P<0.05 when compared to the 80-100% group Hospitalization Risk Sokol etal. Med Care 2005;43: 521-530
Impact of Medication Adherence on All-Cause Healthcare Costs *P<0.05 when compared to the 80-100% group + P<0.05 when compared to the 80-100% group in Diabetes and Hypercholesterolemia Patients Sokol etal. Med Care 2005;43: 521-530
Potential Barriers to Improving Adherence
Alternative health beliefs
Fear or embarrassment
Unable to “see” results of drug therapy
Lack of choices
Vermiere E, et al. J Clin Pharm Ther. 2007;26:331-342.
What is CMAG?
Developed from concepts presented by the World Health Organization (WHO) 2005.
Case Management Adherence Guidelines or CMAG provides an interaction and management algorithm to assess and improve the patient's knowledge and his/her motivation to take medications as they are prescribed.
The guidelines provide great flexibility in that individual patient needs can be taken into account.
WHO White Paper on Adherence
The World Health Organization has made a strong case that medication adherence is based on three pillars: patient information, motivation, and behavioral skill requirements.
Adherence to Long-Term Therapies: Evidence for Action. WHO 2003