June 01, 2020
By Jason Rose, CEO, AdhereHealth
Medication adherence must become a national priority as we deal with the continued effects of COVID-19. In ordinary times, gaps in medication adherence account for more than half a trillion dollars of unnecessary health care spend and 10% of hospitalizations nationwide each year. We are no longer living in ordinary times. Now more than ever, the health care community must take action to prevent these figures from multiplying and placing further strain on our nation’s hospitals and health care workers as they deal with this pandemic. Here are three reasons why.
First, we know that up to 50% of consumers do not adhere to their medication regimens even under regular circumstances. Oftentimes, a person’s reasons for non-adherence stem from their social determinants of health (SDOH), meaning factors like where they live, where they work and their financial means. The COVID-19 crisis has greatly magnified the influence of SDOH factors, especially with the closure of many businesses in response to social distancing and shelter-in-place orders affecting millions of Americans’ employment.
Many people are suddenly facing the no-win choice between buying food and paying for their medication, and in keeping with Maslow’s hierarchy of needs, they’ll have to cover their most basic needs like food, water and shelter first before they can get to the medication. Health plans can be a lifeline for consumers struggling to meet those needs. By using tech-enabled outreach and an empathetic engagement approach, plans can identify people in need and connect them with resources that can help.
Second, along with more tangible SDOH-related issues, only 12% of Americans have proficient health literacy. Misunderstanding health information contributes to medication non-adherence and increased hospitalizations across the board, and it’s likely that these issues will be exacerbated while consumers have limited access to providers and other health resources. Let’s say a consumer was prescribed a new long-term medication which comes in a 90-day supply with a label that reads: “Take one pill every day for 90 days.” Even if this consumer intends to take the medication as prescribed, they may misinterpret the label to mean that they should stop taking the medication after 90 days and never refill it. When misunderstandings like this take place on a large scale across the population, it often leads to worse outcomes and higher hospitalization rates.
Pharmacists can be an invaluable resource for proactive outreach in situations where a consumer might need guidance on a routine medication but a conversation with a provider is not possible. Forward-looking pharmacies are using sophisticated medication adherence technology to run predictive data analytics that can identify at-risk patients like this early on—for example, when the consumer first starts to skip prescription refills—and prompt a pharmacy clinician to reach out to the consumer and identify the reason for non-adherence. The clinician can then open a judgment-free conversation to help the consumer better understand the situation and connect them with any resources needed to promote adherence. This kind of informed outreach reduces the likelihood of preventable complications or even hospitalization, which is crucial while our health care system is under unprecedented strain.
Finally, while self-isolation is a crucial step in fighting the spread of COVID-19, it comes with complications. The need to self-isolate is even greater for at-risk populations, including the elderly and people with chronic illnesses. Approximately 117 million Americans (or 35% of the population) live with at least one chronic disease, and many people managing chronic diseases require multiple medications to stay healthy and out of the hospital. Many at-risk people also rely on caregivers, rideshares or other social networks to access their medication or even to get groceries, and most of those resources have been shut down to stop the spread of COVID-19.
Traditional home delivery pharmacy programs can be a solution for some people, but they don’t work for every consumer. Mail order and retail drug stores use public couriers such as FedEx or UPS, which means that packages with medication inside are often left in a mailbox or on a doorstep at an unscheduled time. That’s a problem for people with limited mobility or in areas where mail theft is common. Solutions like AdhereRx can addresses these issues by scheduling the delivery of medications using HIPAA-compliant private couriers with the ability to accept cash or space out payments if the patient doesn’t have access to a credit card. We see major improvements in adherence when pharmacists engage with consumers proactively and empathetically to find the roots of a person’s non-adherence. These pharmacists take the time to educate consumers, answer questions in regular Comprehensive Medication Reviews, and work with care teams to coordinate complex medication regimens and avoid drug therapy problems.
Medication adherence has always been a public health issue, but it’s an essential part of our fight against this pandemic. Now more than ever, it’s important to acknowledge the SDOH differences among our population and find innovative and personalized ways to help the more vulnerable people around us. Emerging data from states across the country demonstrates that high-risk communities are disproportionately impacted by the pandemic. Pharmacists can play a critical role in mitigating disparities by addressing SDOH and ensuring the needs of all patients are met. Our efforts to promote medication adherence will save lives, even after the COVID-19 crisis ends.
Jason Rose currently serves as CEO of AdhereHealth, a leading health care technology company focused on medication adherence. With nearly 25 years of experience in health care technology, Jason is a serial health care IT entrepreneur focused on launching disruptive products that drive digital health innovation and have a tangible impact on people’s lives.