Private Care May Improve Medication Adherence

  

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While prescription medications have greatly improved both quality of life and life expectancy for millions of people, even the most advanced medicines are useless when not taken or not taken properly. Fortunately, new strategies that ensure medication adherence may be able to help patients get better sooner, keeping them out of hospitals and nursing homes. Private care can help assure that all medications are taken properly, increasing overall medication compliance.

Medication nonadeherence is when patients do not follow a treatment that is prescribed for them. According to the New York Times, an estimated 125,000 yearly deaths, 10% of hospital admissions and a quarter of all nursing home admissions are due to nonadherence.

Medication nonadherence occurs when:

1.)  Prescriptions are not filled

2.)  Too much or too little of the medication is taken

3.)  Medications are discontinued too early, usually as soon as symptoms disappear

4.)  Patients forget to take prescribed medications

Medication nonadherence is especially prevalent among the elderly, who may have cognitive impairment that keeps them from adhering to a medication regimen. It is also a problem for patients who are taking many medications at once, which often happens immediately after a hospital discharge.

Unfortunately, health care providers may have difficulty assessing medication adherence in these populations. If questioned directly by a provider, patients may not admit their nonadherence, or they may not accurately recall whether they have taken their medications. Prescription refill records only tell providers that a patient has filled his or her prescription – not whether a patient has taken the prescription. Similarly, pill counts do not tell providers whether medications have been taken at the right time and in the right dosages.

To combat nonadherence, health care providers are taking advantage of personal interaction with patients. In a 2001 study of home care patients in Wisconsin, patients with impaired cognition and patients who take multiple medications both benefited from targeted monitoring of medication adherence. Likewise, in Japanese research on elderly home care patients, the lowest adherence rates were for patients who administered their own medication and did not consult with a pharmacist.

One way to ensure medication adherence is through at-home care. With multiple medications coming from multiple pharmacies and providers, a home care provider can conduct a thorough review of prescriptions and help to manage different medications. This is especially important if a patient is recovering at home after spending time in the hospital, since medications are often changed and new medications are added during a hospital visit. A health care provider in the home can assess whether a patient is taking a new medication according to instructions, and how the new medication interacts with existing prescriptions.

Taking medications in the correct dosage, at the correct time and for the full duration of a treatment is essential for health and comfort. Good home care providers ensure medication adherence, which is a key part of managing chronic illness and recovering from an acute medical event.