Today, 82% of adults in the U.S. regularly take at least one medication, while 29% take five or more. Unfortunately, many aren’t taking them as prescribed.[1] According to the New England Journal of Medicine, 33% - 66% of all medication-related hospitalizations that occur in the U.S. are caused by poor medication adherence.[2] Furthermore, half of patients with chronic conditions do not take their medications as prescribed, and close to 30% never even fill them.[3]
Barriers to proper medication adherence are as unique as the individual, thus every population is also unique. However, through one-on-one telephonic health coaching, Health Dialog identified the top six barriers to medication adherence for a long-standing client. While the order is based on an analysis for this specific client, the barriers align with what we’ve seen with other client populations.
Top Barriers to Medication Adherence
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Time Management: This includes forgetfulness, lack of a medication-taking routine, no pill box or medication planner.
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Lack of Knowledge: This can mean not understanding a medication’s proper use, the correct instructions for taking the prescription, the reason for taking the drug or its side effects. Not understanding the benefits of taking a medication, the consequences of non-adherence or general health literacy can also be a barrier.
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Provider Issues: Trust and communication can be a barrier to medication adherence. A healthcare provider may verbally change directions of a prescription, forget to refill a prescription, be unavailable or difficult to reach.
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Lack of Motivation: Difficulty staying motivated can affect long-term medication adherence.
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Side Effects: Experiencing side effects, as well as fears, beliefs and concerns can all be barriers.
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Cost/Financial: The cost of prescription medications, healthcare services or cost of living can prevent the purchase of prescription medications.
Understanding how each individual in your population is impacted by these barriers is critical to improving medication adherence results and reducing healthcare costs. In the coming weeks, we will address the specifics of these medication adherence barriers and discuss the tools and resources that can be used to help members overcome them.
[1] Centers for Disease Control and Prevention (CDC). Medication Safety Basics. https://www.cdc.gov/medicationsafety/basics.html.
[2] Osterberg, L., Blaschke, T. (2005). Adherence to Medication. New England Journal of Medication. N Engl J Med 2005; 353:487-497 DOI: 10.1056/NEJMra05011. https://www.nejm.org/doi/full/10.1056/NEJMra050100.
[3] Brown, M.T., Brussel, J.K. (2011). Medication Adherence: WHO Cares? Mayo Clinic Proceedings.
