Patient Understanding and Improved Adherence

Sethu Reddy, MD, MBA
Published Online: Monday, November 12, 2012
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Merck's Adherence Estimator survey can help health care professionals counsel patients more effectively.
Quite a bit of effort has been directed recently toward helping people remember to take their medicines as prescribed. People can sign up to receive reminder text messages on their cell phones or use pill bottles that glow and chime when it is time to take their medicine.

While these resources can be helpful for people who forget to take their medicines, they don’t address the deeper issues that often cause people to stop taking their medicine as directed or not fill their prescription in the first place.

Research conducted by Merck points to 3 beliefs that help predict who may or may not take a newly prescribed medicine—Commitment, Concern, and Cost. These “3 Cs” can be summarized as whether the patient:
  • Understands why the medicine is needed and is committed to its use;
  • Has concerns about taking the medicine, such as possible side effects; and
  • Is facing any cost issues that may prevent the medicine from being taken as prescribed.
To address these issues, nothing can take the place of health care professionals who take the time to talk with patients about their prescribed medicines. Pharmacists can play a major role in helping patients understand why their medicines are necessary. Surveys show that pharmacists rank among the most trusted professionals in America. They are highly accessible. They are trained to understand potential safety concerns and complications that may arise from the misuse of medicines. And they are in a key position to consult with physicians or other health care professionals when concerns are raised about a treatment plan.

But while pharmacists are well positioned to talk with patients and address their potential concerns regarding a medicine—it doesn’t make them mind readers. Convincing patients to open up about their concerns can be difficult. Unfortunately, without that kind of frank discussion, predicting which patients may not adhere to their prescribed medicines is about as accurate as measuring blood pressure with a yardstick.

That’s why Merck developed the Adherence Estimator—a 3-question survey that may help health care providers to better counsel their patients on taking oral medications for certain chronic conditions. The Adherence Estimator has been validated for newly prescribed oral medications for chronic asymptomatic conditions (eg, high cholesterol). It has not been validated for symptomatic conditions (eg, asthma).

More information about The Adherence Estimator and other resources to help health care professionals improve patient engagement are available at MerckEngage.com/hcp/Rx-For-Health.

Over the last 30 years, many innovative medicines have been developed to treat many of the prevalent conditions in our society. But, of course, medicines can only be effective if people actually take them as directed.

The fact that 75% of American adults don’t take their medicines as directed is a serious public health problem. The cost of drug-related morbidity—including poor adherence—has been is estimated to be up to $290 billion a year in the United States alone.

We not only need innovation in bringing new therapies to patients, but innovations are also needed to help patientstake their prescribed medicines. Leaders across the health care community need to work together to help make that happen.

Pharmacists and other health care professionals can help make a difference by talking with patients to understand and address the barriers to their taking medicines as prescribed.


Dr. Sethu Reddy is vice president of U.S. Medical Affairs for Merck.


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