Federal action sought to curtail drug noncompliance

A new coalition of patient groups, physician organizations, drugmakers, pharmacists and pharmacies is aiming to make headway in battling the persistent problem of medication noncompliance. The coalition, dubbed Prescriptions for a Healthy America and led by the employer- and insurer-backed Council for Affordable Health Coverage, said it hopes to educate lawmakers about the importance of the issue and pursue public-policy solutions to improve drug adherence.

In announcing the effort, the coalition highlighted the results of a survey of 800 U.S. adults conducted in April. Nearly two-thirds of the patients polled said they do not always take their prescription drugs as directed. That figure is worse than previous estimates in the medical literature, such as an Aug. 4, 2005, review article in The New England Journal of Medicine finding that about half of patients are nonadherent. That review found that at least one-third of drug-related hospital admissions were due to noncompliance, adding more than $100 billion annually in health costs (link).

The new survey, conducted by a polling firm on behalf of the coalition, also found broad support for some strategies aimed at improving compliance. For example, 92% favored increased one-on-one communication between health professionals and patients about the consequences of failing to take drugs as prescribed, while 92% wanted clearer information about individual drugs.

Ninety percent said that being able to sync up the timing of prescription refills would be helpful, and about the same percentage saw hope in information technology that allows each physician to see up-to-date information about a patient's prescriptions. Eighty-six percent said mobile reminder apps can help, while 77% liked the idea of email and telephone reminders to take their medications.

Warning from family physicians

The American Academy of Family Physicians is one of the physician organizations taking part in the new coalition, along with the American Academy of Ophthalmology and the American Osteopathic Assn. Bringing together many stakeholders to push for broad policy solutions is critical to improving drug adherence, said Rebecca Jaffe, MD, MPH, a Wilmington, Del., family physician and member of the AAFP's board of directors.

“When people have diabetes, hypertension, hyperlipidemia and are noncompliant — that compounds the complications that will ensue with their diseases later on,” Dr. Jaffe said. “So we are trying in this new patient-centric era to partner with our patients and everyone else on the team to convey to the patient the importance of adherence and how that is going to be helpful and useful to the health care system.”

The coalition said federal legislation and funding are needed to improve care coordination and medication management, and that drug adherence should be integrated into quality measurement and performance improvement initiatives. The coalition also is pushing for health IT systems that enable physicians and others to spot gaps in adherence more easily, as well as more research on which interventions are most effective in improving drug compliance. More information about Prescriptions for a Healthy America is available at the coalition's website (link).