Studies:
The Importance of Medication Adherence CHT 2010 - Full text

Abstract
Non-adherence is a tremendous problem in the United States, causing thousands of premature deaths and demanding care that would otherwise have been unnecessary. The estimated annual cost of patients not taking their medications as prescribed approaches $290 billion. Other non-adherence statistics are shocking:

  • Approximately 125,000 Americans die annually (342 people every day) due to poor medication adherence;
  • Ten to 25 percent of hospital and nursing home admissions are caused by the inability of patients to take their medications as prescribed and directed;
  • The rates of non-adherence to prescription medication therapy have remained stagnant over the past three decades, and recent reviews have shown that as many as 40 percent of patients still do not adhere to their treatment regimens and up to 20 percent of all new prescriptions go unfilled.
Enhancing Prescription Medicine Adherence August 2007 - Full text

Abstract
Mounting evidence shows that poor medication adherence is pervasive and costly. The problem affects all ages, both genders and people of all socioeconomic levels. Non-adherence is particularly important for patients with chronic conditions as it leads to unnecessary disease complications, reduced functional abilities, a lower quality of life and too often, premature death.

Medication Costs, Adherence, and Outcomes 2003 - Full text

Abstract
In a two-year period more than two million elderly Medicare beneficiaries did not adhere to drug treatment regimens because of cost. This poor adherence tended to be more common among beneficiaries with no or partial medication coverage and was associated with poorer health and higher rates of hospitalization. The risk for cost-related poor adherence was especially pronounced among lower-income beneficiaries with high out-of-pocket drug spending. We argue that this pattern of cost-related poor medication adherence should inform the design of Medicare prescription drug benefit legislation.

Primary E-Prescribed Medication Non-Adherence April 2008 - Full text

Abstract
Non-adherence to essential medications represents an important public health problem. Little is known about the frequency with which patients fail to fill prescriptions when new medications are started (.primary non-adherence.) or predictors of failure to fill.

Of 195,930 e-prescriptions, 151,837 (78%) were filled. Of 82,245 e-prescriptions for new medications, 58,984 (72%) were filled. Primary adherence rates were higher for prescriptions written by primary care specialists, especially pediatricians (84%). Patients aged 18 and younger filled prescriptions at the highest rate (87%). In multivariate analyses, medication class was the strongest predictor of adherence, and non-adherence was common for newly prescribed medications treating chronic conditions such as hypertension (28.4%), hyperlipidemia (28.2%), and diabetes (31.4%).

NEHI Research Shows Patient Medication Nonadherence Costs Health Care System $290 Billion Annually August 2009 - Full text

Abstract
The New England Healthcare Institute (NEHI) today released new research showing that patients who do not take their medications as prescribed by their doctors cost the U.S. health care system an estimated $290 billion in avoidable medical spending every year. NEHI, a nonprofit health policy organization, recommends four key actions that can best improve medication adherence.

NEHI's research, contained in the new report, Thinking Outside the Pillbox: A System-wide Approach to Improving Patient Medication Adherence for Chronic Disease, notes that one third to one half of all patients do not take their medications properly. Patients with chronic diseases . which affect more than half of all Americans . are particularly susceptible to spotty adherence practices that leave them vulnerable to otherwise unnecessary hospitalizations and additional medical risks. According to one study of diabetes and heart disease patients cited by NEHI, mortality rates among patients who did not adhere to their medications were nearly double the rates of those who took their medications as prescribed.

New Prescription Medication Gaps October 2009 - Full text

Abstract
Study Design. In a new prescription cohort design (27,329 subjects prescribed new medications), we used pharmacy utilization data to estimate adherence during 24 months follow-up. Proportion of time without sufficient medications (medication gaps) was estimated using a novel measure (New Prescription Medication Gaps [NPMG]) and compared with a traditional measure of adherence.

Principal Findings. Twenty-two percent of patients did not become ongoing users (had zero or only one dispensing of the new prescription). The proportion of newly prescribed patients that never became ongoing users was eightfold greater than the proportion who maintained ongoing use, but with inadequate adherence. Four percent of those with at least two dispensings discontinued therapy during the 24 months follow-up. NPMG was significantly associated with high out-of-pocket costs, self-reported adherence, and clinical response to therapy.

Conclusions. NPMG is a valid adherence measure. Findings also suggest a larger burden of inadequate adherence than previously thought. Public health efforts have traditionally focused on improving adherence in ongoing users; clearly more attention is needed to address nonpersistence in the very first stages after a new medication is prescribed.

Electronic health records (EHR) to improve medication compliance November-2010 - Full text

Abstract
The Annals article showed that, eventually (within 1 month), most prescriptions are filled . although the study looked almost exclusively at the prescriptions given to patients with insurance. The medication abandonment rate has not been studied in as thorough a way for patients who lack insurance (or who have very large out-of-pocket deductibles for prescriptions). However, prescriptions given to a patient for the first time, prescriptions that were delivered to the pharmacy electronically, and prescriptions for which the patients have a higher copay were more likely never to be picked up.

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