The following guest post on the subject of drug adherence is written by Janet Wright, Senior Vice President, Science & Quality, at American College of Cardiology.

If the Disruptive Women series on medication adherence has shown anything, it’s that there is a nearly endless number of potential solutions to address the nearly endless number of reasons patients and their prescribed medications do not “stick.”. Over decades of practice in cardiology, I had a first hand view of the challenges patients face in adherence – inability to afford the prescription to incomplete understanding of a med’s value or benefit to overestimating the risk to unclear directions or complex instructions on how and when to take the drugs..

Now, in a staff role at the American College of Cardiology, I join others in the search for solutions to help other cardiologists and health care professionals improve adherence to complicated medication regimens. Successful medication adherence is not a failure on the part of the patient to take their medication, but rather a failure on the part of the health system – including patients, their providers, the reimbursement structure, the insurance companies, etc. – to make it easy and worthwhile for the patient to take his or her medicines..

In July a group of key stakeholders met to brainstorm potential solutions to improve medication adherence. The sponsoring groups represented the major players in improving medication adherence – the drug stores (National Association of Chain Drug Stores), the drugs (PhRMA, GlaxoSmithKline), the patient (National Consumers League) and the ACC representing the physician joined the coalition this fall. In addition to these groups, there were about 40 leaders in the field who shared their wisdom. With the knowledge gained from the discussion in July and in the context of the proposals being considered by Congress, the group is formally recommending five solutions that will improve medication adherence:

Quality Improvement Strategies. Many of the Congressional proposals being considered focus on how to improve quality in the health care system. It is imperative that any national quality improvement effort explicitly acknowledge and address medication adherence as one of its aims.

Care Coordination. Many of the proposals being discussed also include methods to improve care coordination. To improve medication adherence, any care coordination plan must include one often overlooked person – the patient. By having open discussions with our patients about the importance and rationale of each medication prescribed and allowing patients to ask questions and give feedback, we increase the chances of desired outcomes all around. .

Use of Health Information Technology (IT). With the passage of the health IT provisions in the stimulus bill, the number of offices and hospitals using technology is likely to increase. We must demand that health IT have the ability to improve the flow of medication information between patients and their physicians and identify gaps in patients’ medication use. A crucial component of that, as mentioned by Julie Murchinson in her post, will be using technology to engage patients in the management of their medications.

Patient and Provider Education and Engagement. The fourth recommendation addresses physicians helping patients to help themselves. As patients understand their conditions and the benefit of meds in managing those conditions, adherence increases. It’s up to providers to make this happen. If they don’t understand, there’s no hope that 6 months, a year, two years out they’ll still be taking the medications they need to live active and healthy lives.

Health Services Research. More research on medication adherence is needed to understand what we know and what we only think we know. By studying under-researched areas in medication adherence, we can begin to close the research gaps and better understand what methods work best for improving adherence and improving clinical outcomes.

Successful patient medication adherence is not just about the patient taking his or her medication – it’s about the health system working together to allow the conditions to exist to enable the patient to take his or her medication. The time has never been better to implement the solutions explored during this series.

This entry was posted on Wednesday, November 11th, 2009 at 8:09 am and is filed under Drug Adherence, Guest Posts. You can follow any responses to this entry through the RSS 2.0 feed. You can leave a response, or trackback from your own site.