What is Medication Adherence?

Christopher Ciano

What is Medication Adherence?

Christopher Ciano

Approximately 80 percent of older adults have at least one chronic condition, and 68 percent have two or more. Managing chronic conditions such as high blood pressure or diabetes often requires a person to take several medications. Among older Americans (aged 60 and over), more than 76 percent use two or more prescription drugs and 37 percent use five or more.1

Medication adherence, or taking medication as prescribed by your doctor, is one of the most effective ways to manage chronic diseases. Unfortunately, among patients with chronic illness, approximately 50 percent do not take medications as prescribed.2 Furthermore, studies have shown that the more times a day your loved one needs to take their medication(s), the more challenging it can be — especially as they age.3,4  

For caregivers, we know how important it is to have a good handle on your loved one’s health care. Understanding the barriers to medication adherence, along with how best to overcome them, can help bring peace of mind and set both you and your loved one up for success.  

Financial Barriers to Medication Adherence

For some, issues pertaining to adherence start simply because they can’t afford their medication in the first place. It’s important for seniors in this situation to know that enrolling in a Medicare Advantage plan or a Prescription Drug Plan (PDP or Medicare Part D) can help manage the increasing cost of prescription drugs. 

Caregivers can also review a plan’s formulary (list of covered prescription drugs) with their loved ones. A formulary contains different drug tiers, including generic, brand-name or preferred brand-name. Each tier has different costs (generic being the most affordable). Ensuring your loved one’s preferred pharmacy is in their plan’s network can also greatly affect both coverage and cost.

If your loved one can afford their medications but fails to take them properly, their wallet could still feel the effects. As a result of not taking medications as prescribed, your loved one may develop symptoms that require new medications — or even hospitalization, which can further add to their health care costs. While no one wants to see their hard-earned dollars go to waste, this situation can be particularly challenging for seniors who are often living on a fixed income. 

Helping Your Loved Ones Stay on Track

While the financial aspect of medication adherence is a major concern, it isn’t the only one. Without the proper dosages and intake, your loved one’s health may suffer rather than improve. This is where medication non-adherence becomes such a serious issue and, in some circumstances, can be fatal. Medication non-adherence leads to 125,000 deaths and up to 25% of hospital admissions each year.5 Here are three medication adherence strategies to try with a loved one.

Set-Up a Calendar

For many seniors, part of what can be so challenging is simply remembering what medications to take and when. Consider setting up a calendar or using a medication adherence app to help. There are also pill organizers available to suit different needs, including weekly and monthly options with AM and PM sections for taking different medicines at different times of the day. For those with medicines that are dangerous when doubled, there are even organizers with locked compartments that open at scheduled times. 

Explore Delivery Options

Another common challenge can be getting to the pharmacy. Check to see if your pharmacy offers home delivery services or mail-order options. This can make staying adherent more convenient and less stressful for seniors and their caregivers alike. 

Make a List

Last, keep a list of all your loved one’s medications up-to-date and on hand for every routine health visit, as well as emergency care and hospital stays (this tracker from the FDA may help). It can help start conversations around medication adherence with your loved one’s doctor who can provide specific advice on best practices to manage your loved one’s individual needs. In emergency situations, having an updated medication list is vital to make sure your loved one receives coordinated and continued care.

Additional Resources for Medication Adherence Support

We realize that it isn’t always possible for you to do it all. For that reason, CVS Health is currently working to improve medication adherence with tools and programs that educate, remind, and encourage members to stay on track with their medications. This includes a suite of digital offerings that integrate adherence support into daily life, simple devices that can remind members to take their medication on time, and multi-dose packaging options that can help members organize their medications to reduce dosing confusion.

Through our Pharmacist Panel program, specially-trained pharmacists can help Aetna Medicare Advantage members with chronic conditions and potential gaps in care take actionable steps to achieve better health. Pharmacists reach out to these members — either in-person at their local CVS Pharmacy or via telephone — to deliver personalized clinical recommendations. 

A recent CVS Health survey found that 57% of caregivers agree that they do not prioritize their own mental health because they are focused on taking care of others. Accordingly, our hope is that in offering education, tools, and programs that enable seniors to have a better grasp on medication adherence, we can provide a lift for some of the many responsibilities already on caregivers’ plates.

References

  1. Gu Q, Dillon CF, Burt VL. Prescription drug use continues to increase: U.S. prescription drug data for 2007-2008. NCHS data brief, no 42. Hyattsville, MD: National Center for Health Statistics. 2010.
  2. Sabaté E Adherence to Long-Term Therapies: Evidence for Action. World Health Organization, Geneva, Switzerland. 2003.
  3. Claxton AJ, Cramer J, Pierce C. A systematic review of the associations between dose regimens and medication compliance. Clin Ther. 2001;23:1296-1310
  4. Salzman C. Medicine compliance in the elderly. J Clin Psych. 1995;56(suppl 1):18-22
  5. Kim J, Combs K, Downs J, et al. Medication Adherence: The Elephant in the Room. U.S. Pharmacist. 2018;43(1)30-34.

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