EDITORIALMedication Adherence: Hope for Improvement?
Section snippets
Where Adherence Works
Incredibly high medication adherence, even for cardiovascular therapy, is achieved in the ecosystem where researchers evaluate experimental premarketed drugs, also known as efficacy evaluation settings. For example, the landmark 4S clinical trial of the lipid-lowering drug simvastatin prospectively studied 4444 patients newly starting this investigational drug vs placebo and followed up patients for an average of 5.4 years for major cardiovascular events and mortality. Astonishingly, 90% of
The Wired World of Medications: An Upside Opportunity
The only aspect of our health care system that is 100% wired on a national basis and interactive in a real-time environment is our outpatient system of pharmacy. Stimulated by the Omnibus Reconciliation Act (OBRA) of 1990,5 which tied Medicaid pharmacy reimbursement to mandatory real-time drug-drug interaction evaluation, all US pharmacies (>60,000) became electronically wired and currently use the exact same data definitions and coding nomenclature to both send and receive interactive
New Opportunities for Improving Adherence
A key finding in the article by Dunlay et al1 was that economic concerns may prevent consistent medication adherence among patients with chronic heart failure. As noted in this study of patients treated in Rochester, MN, many more nonadherent patients report economic concerns as a key reason for skipping doses or stopping drugs altogether, whereas fewer adherent patients report having this issue. As substantially more small-molecule drugs lose patent protection and become generic, and as
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Cited by (19)
Medication Nonadherence: There's an App for That!
2018, Mayo Clinic ProceedingsCitation Excerpt :Second, and perhaps most important, some of the smart technologies will increase the cost of medications as pharmaceutical companies pass along the costs of imbedded sensors and alarm-integrated pill bottles to consumers. Ironically, cost is the most powerful barrier to adherence, and more patients may choose to not fill prescriptions when they are rendered more expensive.2 One study on medication adherence in a community-based heart failure cohort found that 18 patients (10%) reported not filling a new prescription because of cost, 14 (8%) stopped a medication for the same reason, and 8 (4%) skipped doses to save money.25
Medication adherence in older adults: The pillbox half full
2014, Nursing Clinics of North AmericaCitation Excerpt :A Global Positioning System sensor in the smartphone communicates with a remote server that is accessed by health care professionals. In 2011, researchers began exploring similar technology where the ingestion of pills can be remotely monitored by electrical impulses that are created from natural substances released when the pill is swallowed.44 Technology provides many new approaches to address nonadherence, and technology is attempting to be senior friendly.
Comprehensive Geriatric Assessment
2021, Geriatric Gastroenterology, Second EditionA systematic review of adherence in Indigenous Australians: An opportunity to improve chronic condition management
2017, BMC Health Services ResearchHow to create cooperative patient for antihypertensive and hypolipidemic therapy
2017, Vnitrni Lekarstvi
Dr Epstein is employed by Medco and has stock ownership in the company.