It’s Time to Solve the Intractable Challenge of Medication Non-Adherence

Medication non-adherence remains an intractable challenge. Nearly1/3 of patients fail to initiate therapy and among those who do initiate therapy, nearly 50% discontinue therapy in the first year.

Despite the primary care physician’s role in treatment selection and management of care, their ability to monitor and support patients’ long-term use of medication has been limited by lack of actionable data on adherence.  Nearly every aspect of a patient’s health and care – except medication purchases – is recorded in the electronic health record.  In practice, this means that even the simple act of understanding if patients are taking medications can be difficult to assess with confidence.

In 2014, my health system started receiving purchased and dispensed prescription medication history.  This medication history is loaded into the electronic health record, and reviewed with the patient during the medication reconciliation process. These data are also available for physicians to review with patients.  However, as evidence suggests, simply making data available is insufficient to ensure their use.

To make these data actionable, we developed and piloted an application that allows a physician to access and view a graphical summary of patient adherence during an office visit.  The application was developed to support both clinical decision making and patient engagement.  However, its use was completely optional.  In this project, we evaluate the physician and patient factors associated with use of the application during a face-to-face encounter with a patient.

Over the next several months, we’ll be gaining experience with this promising new technology.  Partnering with clinicians and patients to provide the best and most actionable insights available.