So it’s not a big deal if patients skip a pill or two? On the contrary. Several studies have looked at the issue and the range of their findings is exceptionally broad. One thing that cannot be disputed: The cost is extraordinary. On the low end of the range, the lack of adherence to medications costs the U.S. health care system $100 billion annually in direct costs.
The high end: $289 billion.
The reasons are obvious: In the absence of therapies, diseases and conditions aren’t slowed or defeated.
So the Agency for Healthcare Research and Quality took a look at a number of academic studies to determine if anything could be gleaned from an overview of interventions. Indeed, there are — but with caveats. Some interventions worked well with some diseases and conditions and less well with others. Some successful interventions were more expensive than others. And some interventions didn’t have enough credible information to determine whether they worked in the first place.
But AHRQ researchers did come up with some answers. Perhaps not surprisingly, the one near-universal successful intervention was reducing how much patients paid for their medicine. Generally speaking though, the researchers found that educational interventions and case management “offer the most consistent and voluminous evidence of improvements in medication adherence across varied clinical conditions.”
Educational interventions seemed to work particularly well with asthma; a self-management intervention for asthma was lauded, and it featured several components of educational intervention. But that method worked less well with those who were suffering from hypertension, hyperlipidemia and heart attack. Case management — or collaborative care — also worked particularly well in patients with depression.
The report also notes that while there’s no reason to think any of these interventions to improve medicine adherence will result in unintended negative consequences. But, they add, there have been so few studies looking at the issue that negative consequences can’t be completely ruled out.