To Know But Not Do: The State of Rx Adherence in the U.S.

Apr 25, 2018
How Technology Enabled Solutions Help Patients Overcome Barriers to Medication Adherence
  • Adults
  • Caregivers
  • Female
  • Male

Jennifer Article

Many Americans on medications for chronic diseases are not concerned about missing doses, don’t appreciate reminders from their spouse or partner, and think they do a better job than others at taking their medication as prescribed. That’s according to a new survey, Knowing But Not Doing: The State of Rx Adherence in America Report, that we completed in collaboration with Russell Research.

According to the findings, nearly one-third of those taking prescription medications for chronic conditions say they are not concerned about forgetting to take their medications despite the fact that almost one-half believe it is the most important thing they can do to protect their health. They also don’t want to be nagged by their spouse/partner about taking their medicine, rating them as the most annoying source of reminders to take their medicine.

Although not concerned if they miss a dose or two, people still give themselves high marks for taking their medication as prescribed:

• 54% of respondents claim they do a better job of it than others — this is especially true for people aged 55 and older (60 percent).

• Those who consciously decide not to take their medication regularly report side effects as the primary reason (44% of respondents), followed by an inconvenience (28%).

Incentives Help the Medicine Go Down

The survey also suggests that financial rewards are one effective way to motivate patients to be adherent. Two-thirds of those polled say they are more likely to take better care of their health and adhere to their medications when rewarded for their efforts, and those numbers skyrocketed among the younger population (88% for those ages 18 - 34). Personal financial rewards were cited as the overwhelming preference (82%), while charitable contributions were chosen by a mere 3% of respondents.

While human reminders are not viewed favorably, technology-based medication reminders are seen as helpful tools, especially among adults under age 55: 74% of those ages 18-34, and 62% of people ages 35-54 believe that assistance from mobile health apps or wearable devices would help them be better at taking their medicine.

Advanced Technologies Address Adherence Avoidance

The results of this survey suggest that while patients with chronic diseases know that medication is critical to their treatment and health, they don’t always act on that knowledge. Solutions that help patients, clinicians and caregivers work together to overcome barriers to adherence is essential to our overall health and wellbeing.

Given that patients are more open to technology to help them improve adherence, Express Scripts partners with Mango Health, a mobile health company that provides a daily health management platform to improve health outcomes by improving healthy behaviors, including medication adherence.

The Mango app helps patients develop healthy habits and manage their medication adherence by tackling the biggest driver of non-adherence: forgetting. It helps people follow their doctors’ instructions by making it easy to track the medication schedule and set up reminders, and facilitates ordering prescriptions directly from their device with the pharmacy of their choice. The app also educates patients about their chronic conditions, and offers solutions for caregivers who can track their loved one’s medications even when living in different cities.

Express Scripts also partners with other healthcare technology companies, such as Propeller Health, Livongo and LifeScan, to improve adherence and treatment outcomes through real-time remote monitoring, which helps members and their Express Scripts specialist pharmacists better manage chronic conditions including diabetes, asthma and COPD, and address adherence issues immediately.

Predicting Nonadherence

Predicting medication nonadherence before it starts is another way Express Scripts helps patients stay on track with their therapy. Through ScreenRx®, Express Scripts’ proprietary, real-time, disease-specific predictive model, we identify patients at risk of nonadherence with as much as 94% accuracy, and then personalize interventions -- delivered by specialist pharmacists -- to help patients overcome the barriers to adherence and stay on their therapy.

We see the highest rates of medication adherence across our 80 million members who use the Express Scripts and Accredo pharmacies, where patients are supported by data-driven resources and specialist pharmacists who understand their medication needs and issues. The next best rates of adherence are among those in plans that offer a 90-day supply coverage through a retail pharmacy or home delivery. Once patients with chronic conditions are on stable doses of their medication, these options offer higher adherence, fewer opportunities to forget refills and renewals, and lower costs per day of therapy than the traditional 30-day supply of medication.

About the Research

The research, conducted in February 2018, surveyed 800 adults (age 18 and older) taking medications to treat any of the following chronic diseases: diabetes, hypertension, high cholesterol, heart disease, depression/mental health, gastrointestintestinal disorders, respiratory/asthma/COPD, cancer and arthritis.

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