Some 30 percent of medical prescriptions never get filled, according to a study cited by the New York Times. The study also found that patients that see the doctor more frequently are more likely to fill their prescriptions, and that medicines with high co-pays were less likely to be purchased.
The correlation between doctor contact and medication adherence is an important one. This is one of the reasons that Medicare launched its Chronic Care Management program (CCM) in 2015. CCM reimburses doctors for “non-face-to-face” contacts between office visits. This means that doctors and their staff can contact patients via phone, email, text or another channel and still get paid, incentivizing doctors to supervise these patients. Among the requirements for practices implementing CCM is a monthly assessment and medication reconciliation, and for all of a patient’s doctors and caregivers to communicate through a centralized portal.
Patients with chronic conditions account for about 15 percent of the population and some 80 percent of Medicare spending. Medication adherence or mismanagement is growing to be a costly problem in terms of outcomes and dollars. The Network for Excellence in Health Education (NEHI) reports that of the approximately 187 million Americans who take one or more prescription drugs, up to one-half do not take their medications as prescribed and as many as 2 billion cases of poor medication adherence each year are avoidable.
Not taking medications as prescribed costs over $100 billion a year in excess hospitalizations. Much of this is attributed to people with chronic conditions. Among hypertension patients, an estimated 89,000 premature deaths per year could be avoided with appropriate medication treatment. Diabetes patients with poor medication adherence have a 30 percent yearly risk of hospitalization, as opposed to a 13 percent risk for those who accurately follow prescriber guidelines.
High Cost of Medications
The NEHI report echoes the study cited in the New York Times in stating that the primary reason for medication adherence problems is the high cost of medications. The second reason for non-adherence has to do with care coordination–also similar to the study cited by the Times. People with chronic conditions are often prescribed multiple medications from multiple doctors, and may also have home care providers in the mix. There are plenty of opportunities for the left hand and the right hand to miscommunicate.
Chronic Care Management and Adherence
CCM has the potential to reverse many of these disheartening numbers. With more frequent doctor contact and coordination of care, better medication reconciliation will hopefully reduce adverse events. What CCM doesn’t change, yet, is the cost of medications. Because treatments for chronic conditions can be expensive, the issue is an important one.
Not all practices have implemented CCM. Patients and caregivers of people with multiple chronic conditions should ask their primary care doctor about CCM and if it is available to help reduce the risk of medication mismanagement.
Universal Medication Management is a CCM service provider that helps physician practices implement and manage CCM programs. UMM also offers an electronic pillbox that can send alerts and notifications to patients and caregivers when a medication is taken, or is missed, giving peace of mind to patients and their support teams.