Conclusions and Implications for Public Health Practice:
More than one in four Medicare Part D beneficiaries using anti-hypertensives were non-adherent to their regimen, and certain racial/ethnic groups, states, and geographic areas were at increased risk for non-adherence.
About a third of patients noncompliant; some take other illicit drugs instead
About half of patients in the U.S. don’t take their medications as prescribed, including patients who have had heart attacks.
I actually started to write something really, really snarky but better judgement prevailed. Why even mention people who discontinue statin use without their physician’s knowledge, have a myocardial infarction and two drug eluting stents all while denying the MI ever occurred and maintaining belief that the second stent was not necessary?
Why write about the Standard offer for life coverage? I was asked to review the medical records for my opinion.
Standard? I think not.
OK boys and girls, listen up. When you see the terms non-adherence or non-compliance in that APS you’re reading does this mean the risk is better or worse?
For the study, Canadian researchers evaluated the electronic health records of 15,961 patients in a primary care network that included 131 physicians to estimate the incidence of primary nonadherence (failure to fill a first-time prescription) and to ferret out which drug, patient and physician characteristics might be associated with nonadherence. Patients’ health records were linked to insurer data on drugs dispensed by community-based pharmacies in relation to specific office visits.
The researchers found that slightly more than 31 percent of all initial drug prescriptions were not filled within nine months. Nonadherence was highest for expensive drugs and preventive therapies for chronic conditions such as ischemic heart disease and depression. In addition, patients with higher copayments, recent hospitalization and more severe comorbid conditions were at increased risk for nonadherence.
The two diseases with the highest avoidable noncompliance costs are hypercholesterolemia $44 billion and diabetes $24.6 billion, the study found.
It’s a common problem. According to an April 2011 Mayo Clinic Proceedings article, only about half of those who are prescribed medication take it exactly as prescribed.
Read in between the lines when reviewing medical records. Adjust your risk assessments accordingly. Decline if warranted.
Despite efforts to change the term to the slightly more accurate “nonadherent,” the word “noncompliant” remains firmly entrenched in the medical lexicon. No matter what it’s called, however, it’s an enormous problem. Experts estimate that some 50 percent of patients do not take their medicines as prescribed or follow doctors’ recommendations.
Underwriting and mortality issue? I think so.