Study evaluates impact of medication adherence, comorbidity on workforce productivity

A new study suggests that while medication adherence is a critical element in reducing the impact of illness, employers should view it as just one of multiple components that are needed in strategic employee disease-management initiatives.

The study, published this week in the June issue of the Journal of Occupational and Environmental Medicine (JOEM), suggests that individual health risks and comorbidity - that is, the presence of more than one chronic disease - remain significant predictors of reduced workplace productivity, even in a population with a high rate of medication adherence. The study found significant links across the population studied between high health-risks and lower job performance, while comorbidity was a significant predictor of absenteeism in five of the study's nine subsamples.

Researchers gathered data from more than 64,000 workers with chronic health conditions, spread over five employers, making it one of the largest studies of its kind. The analysis evaluated the impact of medication adherence, comorbidity, health risks and other factors on markers of workforce productivity such as absenteeism and job performance (also known as "presenteeism"). The research was coordinated by a team from the American College of Occupational and Environmental Medicine (ACOEM), Alere Health, and the Integrated Benefits Institute (IBI), and was funded by the National Pharmaceutical Council (NPC).

The study corroborates previous evidence linking the number of comorbidities in employees with their level of absence from work.

"Our analysis suggests that to be most effective, workforce health and productivity initiatives require integrated prevention strategies," said Ron Loeppke, MD, MPH, FACOEM, vice president of ACOEM and lead investigator of the study. "These include primary and secondary prevention, such as wellness and screening services, as well as tertiary prevention, such as medication adherence and disease management."

"Employers should understand that every individual presents a unique combination of health risks and comorbidities, and they should be wary of focusing on single diseases or one-dimensional approaches as they assess worker health," he said.

The study is a follow-up to a 2009 study by the same group titled "Health and Productivity as a Business Strategy," which suggested that employers' health-related lost productivity costs for chronic diseases are significantly higher than their medical and pharmacy costs. The 2009 study recommended further research on the impact of medication adherence on lost productivity.

While more investigation is needed on the connection between health-risk status, comorbidity, and medication adherence on productivity, the authors said the study strongly supports the need for employers to manage the growing impact of chronic disease on their workers.

"Our earlier study demonstrated that chronic health problems are costly for employers and must be taken into account," said Vince Haufle, MPH, senior healthcare analyst for Alere. "This study offers further support of that finding, while demonstrating that comorbidities and health risks are a more important part of the equation than many employers may realize. The findings highlight that comprehensive services are needed to help improve worker health and manage costs."

Thomas Parry, PhD, president of IBI, noted: "While the cost and impact on productivity from chronic disease continues to rise in the workplace, it's important to remember that chronic health conditions, in many circumstances, are preventable. That's why continued research and better understanding of chronic conditions are essential to workplace productivity, and why prevention should be a foundational underpinning of our national efforts aimed at this problem."