Don’t Blame Doctors For Medication Non-Adherence, Enlighten Patients!

Non-adherence to prescribed medications is ‘an out-of-control epidemic’ in the United States, says an article published in the New York Times. This article which discusses a review in Annals of Internal Medicine, says that 125,000 people die each year in the country due to non-adherence. If medication non-adherence in tracked by the Centers for Disease Control and Prevention, it would rank as the sixth leading cause of fatality here. Further, non-adherence also causes 10% of hospitalizations here. The cost of these hospitalizations account is a minimum of $100 billion to a maximum of $289 billion each year.

 

 
Level of non-adherence to prescribed medications in the U.S.

Talking about the extent of non-adherence, the review states its finding as “20-30% of medication prescriptions are never filled, and approximately 50% of medications for chronic illness are not taken as prescribed.”
For instance, the study found that 41% of heart attack patients do not consume their blood pressure medications, one third of kidney transplant patients do not consume their anti-rejection medications, and 50% of asthma affected kids either use inhalers inconsistently or do not use them at all.
Reasons for Non-Adherence

The article discusses several reasons for non-adherence. These include disinclination to chemicals, aspiration to do things naturally, avoidance of these reminders of illness (medications), self-experimentation by ceasing the intake of medications and observing no distinguishable change in health, and cost of medications.
Another article posted in in the New York Times discussed a study of the pattern of stopping prescription consumptions for high-intensity statins by Medicare patients. All the 30,000 participants involved in the study were Medicare beneficiaries who had Medicare pharmacy benefits and fee-for-service coverage. However, it was found that only 58.9% of the patients were consuming those prescribed medications at six months after discharge. This percent further reduced to 41.6% at two years.

The role of doctors in non-adherence

Other than the previously listed reasons, it is also believed by some that non-adherence to medications is owed to those doctors who fail to educate their patients regarding the significance of consuming their medications.
Dr. Robert S. Rosenson, the lead author of the statin study, told the New York Times “Health care providers have an obligation to educate the patient. We need to stress the evidence that supports the therapy. People who continue the medicine have progressively fewer adverse outcomes over time. Once you have a heart attack, this is prevention for the rest of your life.”
However, one shouldn’t entirely blame the doctors for this. For, they have been extensively educating and using other measures for the past 50 years to eradicate cigarette smoking from the country. But despite their efforts, the cigarette smokers’ percentage has gone down from >42% to about 15% only in these 50 years, indicating that 36 million people still smoke.
So, instead of blaming doctors for the issue of medication non-adherence, it is important to concentrate on methods to enlighten the patients. Patient advocate groups and foundations should promote awareness of non-adherence through colored ribbons, and fundraising runs, walks, swims, jogs or trots. Here is a slogan from a physician for public awareness on non-adherence- “If you want to make it, you’ve got to take it”.

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