Doctors Should Screen Patients to Assess Consistency in Taking Prescribed Medications, Pitt Professor Recommends
PITTSBURGH, May 22, 2013– Doctors should assess their patients to determine if they are consistently taking prescribed medications for long-term ailments and treat patients’ non-adherence behaviors as they would other medical problems, according to a University of Pittsburgh School of Medicinearticle published today in the Journal of the American Medical Association.
Between 30 and 50 percent of U.S. adults do not adhere to chronic long-term medication regimens, leading to an estimated $100 billion in preventable costs annually, noted Zachary A. Marcum, Pharm.D., MS, Assistant Professor of Medicine at Pitt and corresponding author of the paper. Despite the widespread prevalence and cost of medication non-adherence, the problem goes undetected and undertreated in a significant proportion of adults.
“We propose medication non-adherence be viewed as a diagnosable and treatable medical condition,” said Marcum. “The first step is to conduct screening that will allow us to identify this condition.”
While there are reliable screening tests to ‘diagnose’ medication non-adherence and treatments available for those not properly taking their medications, the authors note most clinicians are not formally trained to screen for and diagnose medication non-adherence, or on how best to treat the problem if detected.
The authors also note that diagnostic accuracy can be improved by focusing on some of the most common underlying patient factors that often lead to non-adherence: a lack of understanding that medication adherence fosters improved health; a belief that the cost of a medication is not balanced by its benefit; complex or confusing regimens that are hard to follow; lack of vigilance in taking medications regularly; inaccurate, irrational or conflicted beliefs about medications; and perceptions that medication isn’t working.
“Each medication non-adherence behavior requires different diagnostic tools and treatments, in the same way that specific medical conditions require specific treatments,” added Marcum. “An incorrect diagnosis can waste resources and cause harm to the patient.”
The authors contend that screening to ‘diagnose’ medication non-adherence should be routine, and should utilize existing screening tools and survey instruments.
The authors also suggest that measures of medication non-adherence should be included in patients’ electronic health records to allow for sharing among health care professionals, and to monitor trends over time.
They also note that educational interventions with behavioral support and regular patient outreach can significantly improve medication adherence for diseases including hypertension and myocardial infarction.
Future research is needed to formally test this approach to ‘diagnosing’ and treating medication adherence, and the authors of the paper plan on leading that charge.
Co-authors of the article include Mary Ann Sevick, ScD, RN, and Steven M. Handler, M.D., Ph.D., also of the University of Pittsburgh.
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As one of the nation’s leading academic centers for biomedical research, the University of Pittsburgh School of Medicine integrates advanced technology with basic science across a broad range of disciplines in a continuous quest to harness the power of new knowledge and improve the human condition. Driven mainly by the School of Medicine and its affiliates, Pitt has ranked among the top 10 recipients of funding from the National Institutes of Health since 1998. In rankings recently released by the National Science Foundation, Pitt ranked fifth among all American universities in total federal science and engineering research and development support.
Likewise, the School of Medicine is equally committed to advancing the quality and strength of its medical and graduate education programs, for which it is recognized as an innovative leader, and to training highly skilled, compassionate clinicians and creative scientists well-equipped to engage in world-class research. The School of Medicine is the academic partner of UPMC, which has collaborated with the University to raise the standard of medical excellence in Pittsburgh and to position health care as a driving force behind the region’s economy. For more information about the School of Medicine, see www.medschool.pitt.edu.