Multiple interventions improve medication adherence for patients with chronic conditions

Although patients with chronic conditions who do not take medications as prescribed tend to have poorer health outcomes and higher health care costs than those who adhere to medication regimens, a new report sheds light on the potential for multiple interventions to improve medication adherence.

The report, by the RTI International-University of North Carolina at Chapel Hill Evidence-based Practice Center, found that reducing co-payments or improving coverage for prescription drugs, offering case management services, and providing education to patients along with behavioral support are effective ways to increase medication adherence among such patients.

The report, which was funded by the Agency for Healthcare Research and Quality, was published in the Sept. 11 issue of Annals of Internal Medicine.

It is based on a systematic review of 69 studies that assessed the effectiveness of interventions aimed at improving medication adherence for patients with a wide range of chronic conditions. These include high blood pressure, depression, high cholesterol, asthma, diabetes, heart failure, musculoskeletal diseases, heart attack, multiple sclerosis and glaucoma.

The studies in the report included patient, provider, system and policy-level interventions that ranged from low-cost, low-intensity approaches, such as one-time mailed reminders, to more complex interventions, including case management and collaborative care. All were conducted between 1994 and 2012.

"The findings suggest that health care professionals can choose from among multiple effective pathways to improve patients' abilities to follow medication recommendations across numerous clinical conditions," said Meera Viswanathan, Ph.D., a senior research analyst at RTI International and lead author of the report.

This is good news for patients who have trouble sticking to their medication regimes, said Carol Golin, M.D., associate professor of medicine at UNC and co-author, "because it tells them there are tools and programs out there that can help patients adhere better. These findings also highlight the fact that policies that help patients afford to get their medication help them take their medication."

According to the authors, more research is needed to understand what specific elements of the interventions are most successful and to determine how health systems and clinicians can work together to enhance interventions to improve the health outcomes of their patients.