By Jennifer Eder
Ron Michaud suffered his first heart attack at 37.
Ten years later, he had a second bypass surgery. But in 2002 his severe heart failure required him to get a pacemaker and defibrillator while he waited for a heart transplant, which he received two years later.
Today, at 68 years old, Mr. Michaud takes 13 different medications every day to manage his high blood pressure, diabetes, peripheral artery disease, high cholesterol and heart transplant. He credits his survival to his strict adherence to taking his daily medications for the past 36 years.
“I’m a firm believer in this,” he said. “But medical adherence takes planning, tools, a support system from your family and doctor and an informed patient.”
When it comes to Americans, Mr. Michaud is a minority.
Nearly 45 percent of the U.S. population has one or more chronic conditions that require medication yet three out of four Americans don’t take their medication as directed.
On Wednesday at the George Washington University Hospital, the U.S. Surgeon General Regina M. Benjamin and the National Consumers League, a nonprofit organization that promotes social and economic justice for consumers and workers in the U.S., unveiled a national medication adherence campaign. The three-year campaign, titled Script Your Future, aims to raise awareness among patients and their caregivers about the importance of taking medication as prescribed.
“Medication adherence is a public health issue, and we need to raise awareness and take action,” said Dr. Benjamin. “While we can’t prevent chronic conditions, we can prevent them from getting worse. As a family physician, I know that conversations between clinicians and their patients are key to patients’ understanding why taking their medication correctly is so important, particularly in chronic health conditions.”
The campaign’s website provides tools to support patient efforts to adhere to their prescribed medicine. Tools include free text message reminders, medication lists and charts to keep track of medicines, sample questions to ask your doctor or pharmacist and fact sheets on common chronic conditions.
“The tools offered through NCL’s Script Your Future campaign empower patients to talk with their health care teams about their medication questions and concerns,” said Dr. Benjamin.
The campaign will focus on patients affected by three serious chronic conditions – diabetes, respiratory disease and cardiovascular disease – and will target outreach efforts in six cities: Baltimore; Birmingham, Ala.; Cincinnati; Providence, R.I.; Raleigh, N.C.; and Sacramento, Calif.
“There are many different reasons why people don’t take their medicine as directed, from concerns about side effects to the out-of-pocket costs of prescriptions. But the consequences for patients are the same. Non-adherence puts patients, especially those with chronic conditions, at risk for serious complications,” said Sally Greenberg, executive director of NCL, the nation’s oldest consumer group.
More than one-third of medication-related hospital admissions are linked to poor adherence, and about 125,000 deaths per year in the U.S. are linked to medication non-adherence.
William Shrank, assistant professor of medicine in the Division of Pharmacoepidemiology and Pharmacoeconomics at Brigham and Women’s Hospital and Harvard Medical School, said the first step for greater medication adherence is increased communication between doctors and their patients.
“Research shows that patients with chronic diseases often have a poor understanding of their illness, how their prescribed medications work and the consequences of not taking them. Doctors are rarely aware if their patients are taking their medications at all,” said Dr. Shrank. “If we want more patients to take their medications as directed, we need to get doctors and patients to talk to each other. When patients do understand their condition and how medication helps them manage it, they’re more likely to commit to taking their medication.”
The campaign calls on all health care professionals, including doctors, nurses and pharmacists, to be part of the solution to better medication adherence. The campaign is supported by a coalition of nearly 100 public and private partners and sponsors, including health care professional groups, chronic disease groups, health insurance plans, pharmaceutical companies and consumer groups.
Poor medication adherence also contributes to increased health care costs.
According to NCL’s new briefing paper, “Medication Adherence: Making the Case for Increased Awareness,” medication non-adherence is costing the nation anywhere from $100 billion to $300 billion each year from additional doctor visits, emergency room visits, hospital admissions and additional medicines.
“It is estimated that for every additional dollar spent on adhering to a prescribed medication, medical costs would be reduced by $7 for patients with diabetes, $5.10 for people with high cholesterol and $3.98 for people with high blood pressure,” said Cherokee Layson-Wolf, assistant professor at the University of Maryland School of Pharmacy.
Throughout the next three years, the campaign will provide materials to help patients adhere to their medications, host community events and health fairs and evaluate medication adherence awareness through research.
“We know this is a complex issue, but we are committed to helping people script their own future,” said Ms. Greenberg.