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Adherence: Medication Adherence and Patient Compliance

Adherence: Medication Adherence and Patient Compliance

What is
Medication Adherence
Medication Non-Adherence
Patient Compliance?

Adherence is simply taking your medications, or not taking them as the case may be, in any way that differs from the way your health care provider prescribed it to be taken. Non-Adherence (to the prescribed regimen) will result in consequences ranging from unpleasant side effects of the medication to exacerbated symptoms of the condition it was being used for, or even ineffectiveness of the medication. | Learn more about Patient Compliance | VIDEOs | All e-pill Devices |

Quick facts - Patient Compliance / Medication Adherence - List of All e-pill Medication Adherence Devices:

At any given time, regardless of age group, it is estimated up to 59% of those on five or more medications are in non-adherence.
  • 11% of all hospital admissions are the result of prescription medication non-adherence .
  • 23% of all nursing home admissions are due to failure to take medications accurately.

    GOOD / POOR Adherence Adherence, which means taking the right amount of the prescribed medicine at the right time, is being recognized as a major problem in healthcare today. It is more costly and more serious than many major illnesses.

    FACTS: (common non-adherence errors include):

  • Forgetting to take your medicine.
  • Taking the right medication at the wrong time.
  • Taking the incorrect medication.
  • Taking the incorrect dosage (too few or too many pills).
  • Discontinuing taking your medication prematurely.
  • Not filling or refilling a prescription.
  • Double dosing- taking two pills to make up for a skipped one.
  • Combining your medication with an inappropriate food or beverage.

    More than 125,000 Americans die each year due to prescription medication non-adherence, twice the number killed in car accidents.

  • Every day, prescription non-adherence costs more than $270 million in additional hospitalization and other medical costs.
  • 90% of outpatients are taking prescribed medicines improperly, contributing to prolonged or additional illness.
  • People who miss doses need 3 times as many doctor visits as others and face increased medical costs.

    Almost 60% of the prescription medication non-adherence problems could be prevented by improving Adherence.

    When a Doctor or PA writes a prescription:

  • 1/3 of patients take the medicine as directed.
  • 1/3 take some of the medicine.
  • 1/3 never fill the prescription.

    Who Is At Risk? Test

  • Y_ or N_ Do you often forget to take their medication?
  • Y_ or N_ Do you frequently skip dosages?
  • Y_ or N_ Do you discontinue taking medications before the prescription has run out?
  • Y_ or N_ Do you sometimes forget to refill your prescriptions?

    Even ONE "YES" to any of these questions, puts you at serious risk for medication non-adherence health problems.

    More about ADHERENCE: Medication factors (eg, duration, schedule, formulation, palatability, cost, and adverse effects) are clearly associated with adherence.

    Longer duration of the medication regimen and increased complexity of the medication schedule represent risk factors to adherence, with mid-day ('during the day' = nor mornig or at night) dosings being particularly problematic.

    Medication errors are among the most common medical errors, harming at least 1.5 million people every year, says a new report from the Institute of Medicine of the National Academies.

    There is no "typical" medication error, and health professionals, patients, and their families are all involved.

    A medication error is "any preventable event that may cause or lead to inappropriate medication use or patient harm while the medication is in the control of the health care professional, patient, or consumer,"

    Drug Naming, Labeling, and Packaging Confusion caused by similar drug names and similar colored pills accounts for up to 25% of all errors. In addition, labeling and packaging issues were cited as the cause of 33% of errors, including 30% of fatalities.

    Examples of DRUG NAME CONFUSION (reported to the FDA): |Pill ID Identification |

    - Serzone (nefazodone) for depression and Seroquel (quetiapine) for schizophrenia.

    - Lamictal (lamotrigine) for epilepsy, Lamisil (terbinafine) for nail infections, Ludiomil (maprotiline) for depression, and Lomotil (diphenoxylate) for diarrhea.

    - Taxotere (docetaxel) and Taxol (paclitaxel), both for chemotherapy.

    - Zantac (ranitidine) for heartburn, Zyrtec (cetirizine) for allergies, and Zyprexa (olanzapine) for mental conditions.

    - Celebrex (celecoxib) for arthritis and Celexa (citalopram) for depression.

    MEDICATION ADHERENCE Devices: Compare e-pill and other manufacturers Medication Adherence systems and devices:

    Currently the vast majority of home medication dispensers (pill boxes) are passive day/time organizers.

    Automatic Dispenser / Log File / Reporter: There are many practical designs for electronic dispensers featuring computerized delivery and alerting systems. Examples are e-pill Med-Time XL, e-pill MedSmart, e-pill Compumed. Cost for these devices is $300-$900.

    Existing devices: Many “smart” Medication Adherence systems for the home have been accepted in the marketplace. Automatic telephone calls may follow a missed dose. Premature (Early Dose) taking of abusable medicines is not detected by most devices, but we do offer the tamper proof e-pill CompuMed Automatic Pill Dispener when the patient has a history of wanting to get to meds before it is time.

    Blister-Packs (Unit Dose) Self reporting blister-pack - These require specialized packaging by the pharmaceutical manufacturer or pharmacy and are not reusable. It adds about $25 per medication /per month/ per patient to medical costs independent of a monitoring system. Cost for this intervention for a typical patient can be greater than $1500 per year.

    Weight Sensing Canister: These devices detect usage of medication through weight change in a loaded canister for each medication. They are useful in research on adherence with a single medication where weight of a tablet is known and the device is calibrated. However, the system is costly and nearly impossible to apply correctly to a galaxy of drugs where no manufacturer guarantees pills of identical weight. Research units for a single medication cost in excess of $1500. Alternative MDI Inhaler Patient Compliance device: PuffMinder DOSER

    Care Taker Visit: Specialized Chronic Disease Management companies typically oversee adherence by telephone calls to patients, or costly nurses visits to the patient’s home. This is clearly an expensive approach but may be the only method to achieve better patient compliance / medication adherence that the patient will accept.

    Listing of ALL e-pill Medication Reminders

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