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Overcoming Barriers to Medication Adherence for Chronic Diseases

Presented on .

Medications save lives for countless Americans. People with chronic illnesses such as high blood pressure, coronary artery disease, and HIV can enjoy a good quality of life when they routinely take their medicine. Poor medication adherence is linked with poor clinical outcomes. While these facts may seem obvious, a staggering one half of patients in the US stop taking their medications within one year of being prescribed.

The reasons for “medication non-adherence” are varied. Affordability, a lack of understanding of the importance of the medications, and unpleasant side effects are some examples patients cite for not taking their medication as directed. Beyond increased mortality, the result costs the United States billions of dollars per year. Hospital admission rates increase for non-adherent patients with chronic illness by up to 69 percent.

Join our speakers as they discuss research, interventions, education, and emerging tools and technologies that may help overcome these barriers to medication non-adherence.

Future Grand Rounds topics include emerging tick-borne pathogens and the National ALS Registry.

Beyond the Data

Dr. Phoebe Thorpe and Dr. Larry Garber discuss why fifty percent of people with chronic illnesses stop taking their medications within one year of being prescribed. It’s hard to take your prescriptions when you can’t afford the price, have difficulty opening the pill bottle, or you hate the side effects. Some patients don’t believe their medications are helping them. Tune in to hear these reasons and others. Learn how research and technology, along with other successful options, assist patients in sticking to their medication regimen.

Audience Questions
What recommendations you could make to empower patients to be more personally responsible for the care they receive?
  • Examples
    • Lower insurance premiums
    • Patient receive reimbursement for meds they take

That’s an interesting way of phrasing the question. As health care providers, it is difficult to hold patients responsible for their adherence in a way that penalizes them. In order to do so, we would first need to have reliable and valid methods to measure adherence in the clinical setting. Patients pay the price for poor adherence through poorly controlled symptoms and worse health outcomes. It’s possible that some patients aren’t aware of their poor adherence or don’t cognitively link medication adherence with their health outcomes. This may then negatively impact the patients’ motivation & intention to adhere to their medication regimens.

Some patients are making decisions to be non-adherent for a variety of reasons such as side-effects or medication costs. Many of the efforts to change this type of non-adherence seem to be focused on providing additional information to patients or to increased surveillance to check whether the medication is being taken. Unfortunately, better information about the importance of adherence does not make the medication more affordable. What psychological or behavioral interventions are underway to affect the decision-making and motivational processes that lead patients to be non-adherent?

I agree with your assessment that education or even behavioral health interventions won't actually address the root causes of non-adherence. So I discuss ways to mitigate side effects or alternative treatments, or ways to reduce costs (cheaper pharmacies, splitting pills, non-medication interventions, discount websites, pharma discount programs, etc...).

Presented By
Todd Ruppar, PhD, RN
Associate Professor, Sinclair School of Nursing
Associate Director, Meta-Analysis Research Center

University of Missouri
"Understanding Barriers to Medication Adherence"
P. Michael Ho, MD, PhD
Staff Cardiologist, Veterans Affairs Eastern Colorado Health Care System
Professor of Medicine, University of Colorado Anschutz Medical Campus

"Multifaceted Interventions Improve Adherence"
Larry Garber, MD
Medical Director for Informatics
Associate Medical Director for Research

Reliant Medical Group
"Promoting Medication Adherence Through High-Tech and High-Touch"
CAPT Paul J. Weidle, PharmD, MPH
Team Lead, Health Services Research for Prevention with HIV Positive Persons,
Division of HIV/AIDS Prevention

National Center for HIV/Viral Hepatitis, STD, and TB Prevention, CDC
"Broadening Public Health Approaches to Medication Adherence for HIV"
Facilitated By
John Iskander, MD, MPH
Scientific Director
Phoebe Thorpe, MD, MPH
Deputy Scientific Director
Susan Laird, MSN, RN
Communications Director
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Continuing Education
This session is available for Continuing Education (CE).

CDC Course Code: PHGR10
CPE UAN: 0387-0000-17-016-H04-P

For more information, see Grand Rounds Continuing Education.

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