Alexandria, Va. June 25, 2013 - A first-of-its-kind patient survey, Medication Adherence in America: A National Report Card, finds that Americans 40 and older with a chronic medical condition earn a troubling C+ on average and that one in seven members of this group received an F when it comes to taking their medications correctly.
The report card calculated grades based on an average of answers to questions on nine non-adherent behaviors: whether or not in the past 12 months patients failed to fill a prescription; neglected to have a prescription refilled; missed a dose; took a lower dose than prescribed; took a higher dose than prescribed; stopped a prescription early; took an old medication for a new problem without consulting a doctor; took someone else's medicine; or forgot whether they'd taken a medication.
"The academic year has drawn to a close for most students, but when it comes to taking their prescription drugs, it's many of the parents who may require summer school," said National Community Pharmacists Association (NCPA) CEO B. Douglas Hoey, RPh, MBA. "Proper prescription drug use can improve patient health outcomes and lower health care costs, so anything less than an A on medication adherence is concerning. Pharmacists can help patients and caregivers overcome barriers to effectively and consistently follow medication regimens. Indeed, independent community pharmacists in particular may be well-suited to boost patient adherence given their close connection with patients and their caregivers."
Key points from the report card include:
Americans earn only a C+ grade on average in terms of taking their medication properly.
One in seven adults with chronic conditions—the equivalent of more than 10 million adults—received an F grade.
Collectively, one-third of overall respondents received either a D or F.
The grades in this survey may, if anything, understate the non-adherence problem due to the self-reported nature of the answers and potential reluctance among some individuals to admit to undesirable behaviors.
The biggest predictor of medication adherence was patients' personal connection (or lack thereof) with a pharmacist or pharmacy staff. Patients of independent community pharmacies reported the highest level of personal connection (89 percent agreeing that pharmacist or staff "knows you pretty well"), followed by large chains (67 percent) and mail order (36 percent). This predicting factor was followed in order of importance by: affordability of medications; continuity in health care usage; how important patients feel it is to take their medication as prescribed; how well informed they feel about their health; and medication side effects.
"Caregivers are a vital resource for improving the national grade on proper prescription use," said Paul DelPonte, the Director of Programs, Operations and Development for the National Alliance for Caregiving. "Enhanced community partnerships and increased awareness on proper use of medications will make our nation healthier. This study by the National Community Pharmacists Association helps raise awareness of the issues facing caregivers and patients. It's time to improve this grade."
Non-adherence can threaten patients' health individually as well as add vast costs to the health care system—an estimated $290 billion annually, according to a 2009 NEHI estimate.
"This survey reinforces the large role that pharmacy services such as medication therapy management (MTM) and synchronized-refill programs like Simplify My Meds™ can play in achieving gains in patient medication adherence and healthier outcomes," Hoey added. "Thus, it has several direct applications for public and private stakeholders.
"First, Congress should enact the Medication Therapy Management Empowerment Act (S. 557 in the U.S. Senate and H.R. 1024 in the U.S. House of Representatives). This legislation would expand seniors' access to MTM services in the Medicare Part D prescription drug program, without costing the government a dime. Indeed, previous MTM programs have reduced overall health costs as the expanded efforts of pharmacists averted more expensive medical interventions and procedures. Second, NCPA encourages health plan sponsors to support access for patients and caregivers to the pharmacy that best meets their individual needs. Third, patient adherence is about more than just prescription fill rates; plans that rely on just that measurement end up producing unnecessary waste in the health care system. Fourth, payment policies that restrict pharmacy medication synchronization services are short-sighted and undermine more coordinated care efforts."
The survey was conducted among a national sample of 1,020 adults age 40 and older who have received a prescription for a chronic medical condition. As part of the association's Pharmacists Advancing Medication Adherence (PAMA) initiative, NCPA commissioned Langer Research Associates to undertake the poll in order to gauge the extent of prescription medication non-adherence and to explore the attitudes and behaviors that promote or discourage the responsible use of medication. PAMA is sponsored by Pfizer, Merck and Cardinal Health Foundation.
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