Tuesday, May 11, 2010

Three Ways To Improve Patient Medication Adherence And Reduce Admissions

One of the major causes of hospital readmission is the failure of patients to strictly follow the course of medications set out for them upon discharge. This is also a cause for many initial hospital admissions. It isn't because patients are refusing to follow the physician's orders or don't wish to be compliant. But there are other factors involved. A recent study from the New England Journal of Medicine stated that up to half of all patients fail to take their medications faithfully as prescribed thus compromising their health and costing the healthcare system $100 billion per year in preventable hospital stays. There are three steps that can be taken to address this serious issue.

1) Provide more help to patients explaining the various medications. Patients need to know what each medication is for and when it must be taken. Likewise the primary care physician must know the complete set of medications that a patient is on. A patient seeing several specialists may be getting a number of prescriptions with no one coordinating all of these. Some patients could be on as many as ten different medications which is a lot to coordinate without some outside help.

2) Discuss possible side effects of each medication. A patient could be on medications to lower cholesterol and high blood pressure, neither of which give him any symptoms. But the medications when taken correctly make him tired, so he stops taking them figuring he feels better off of the meds. Again, a thorough understand of what each drug is for will help promote compliance. But anticipating the possible side effects will also be very helpful.

3) Consider the patient's financial situation in prescribing medications. Studies have shown that an increase in copayments will reduce the likelihood that prescriptions will be filled. Patients are more likely to be compliant if their out of pocket expenses are minimized. Hopefully some of this will be alleviated on June 15 of this year for Medicare patients when they can receive $250 to help fill the "doughnut hole" in Medicare's prescription benefits.

Some effort in these three areas can not only improve patients' health, but also save some money for our overstretched system.

More on this later.

Mark Brodeur

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