Lack of patient understanding of the true cost of medication non-adherence

A new report released today, Friday 16th October, by Omnicell, throws the spotlight on the ‘missing millions’ in the NHS and the staggering cost to the nation of medication non-adherence.  This wastage, is set against a worrying backdrop of patients who fail to understand the importance of adhering to medication, adopting an almost ‘arbitrary’ approach to taking prescription drugs by making key health decisions on their own and without informing a healthcare professional, a new opinion poll reveals.  The research, which was conducted as part of the new report ‘The true cost of medication non-adherence’ found that;

• one in five adults (21%) admit that they have missed a round of medication that they are meant to take every day
• 12% of British adults say that they have not finished a course of medication, while only 6% say that they have informed their doctor or healthcare professional about this, suggesting that only around half of British adults are telling their healthcare professional when they fail to complete a course
• around one in three people (31%) say they have disposed of medication that they have not used, and 6% say that they have given leftover medication  to ‘someone they knew’
• With any medication left over from a prescription they had not finished, only one in three people (34%) say they would take it to their local pharmacy. One in four say that they would keep it in case they needed it later (25%), or that they would throw it away (24%). – incredibly one in 20 (6%) say that they would be most likely to ‘flush it down the toilet’
• 36% of adults agree that printing the cost of the medication to the NHS on the packaging (a new proposal recently announced by Health Secretary Jeremy Hunt) would make them more likely to take their drugs as prescribed by their doctor or healthcare professional.  However, around half (49%) say that it would not have an impact on how likely they would be to adhere to their medication.

The report, produced as part of a wider adherence campaign by Omnicell ‘Let’s take care of it’ (#letstakecareofit) aims to throw the spotlight on the sheer scale of the waste caused by prescription non-adherence during National Medication Adherence Week, (16th to 23rd October 2015), in the hope that it might focus the attention of all those in a position to instigate change. The vast costs from non-adherence are felt across the entire healthcare system, not to mention the impact on patient well-being and at worse, patient lives. Jeremy Hunt, recently quoted the costs of medicine wastage at a staggering annual £300 million, at least half of which is avoidable, whilst the cost to the NHS of people not taking their medicines properly and not getting the full benefits to their health is estimated at more than £500 million a year(1).  The consequences go far beyond what most patients envisage when they forget to take their pills; in the EU alone, nearly 200,000 deaths occur each year due to missed doses of medication(2).

Omnicell’s research explored the complex reasons why people don’t adhere to their medication. Of those that have not taken their medication as prescribed;

• two thirds (65%) say that it’s because ‘they forgot’
• a quarter (25%) claim that the side effects made them feel ill and
• a further 20% say they did not feel ill and therefore did not think they needed the medication.

Alarmingly, the illnesses that British adults are most likely to say they have been prescribed medication for on the NHS are high blood pressure (21%), high cholesterol (16%), asthma (13%) and mental health conditions (12%).  Those patients with a mental health condition are more likely to say that they stopped taking the medication because it had side-effects that made them feel un-well (35%) or because they did not feel ill and therefore did not think they needed the medication (20%).

For patients where prescribed medication is necessary, drugs play an essential role in the ongoing management of medical conditions.  Medication non-adherence not only leads to substantial worsening of diseases and illnesses, in many instances it causes repeat visits to GP surgeries and hospitals. This is why treatment compliance needs to be front of mind for GPs when discussing overall health with their patients and pharmacists need to support patients with adherence strategies and techniques.

Paul O’Hanlon, Managing Director of UK and Ireland at Omnicell comments; “If you look at all the major chronic illnesses every one of them needs good medication adherence in order to keep them under control.  Take diabetes as an example, the eventual result of poor compliance and not controlling blood sugar levels effectively can lead to poor blood circulation and potentially, amputation of limbs.  Shockingly, around 100 amputations a week are performed on the NHS due to complications from the disease and nearly 1,300 diabetic patients a year go blind due to diabetic retinopathy.(3)”

Paul adds; “There are currently five million patients in the UK that take four or more medications, and a significant number of patients who require further support to take their medication correctly – above and beyond existing adherence systems. None of the reasons why patients are failing to adhere to medication are insurmountable. Better patient education, targeted use of support services by pharmacists and utilising modern technology to aid compliance would go a long way to stemming the flow of resources down the toilet – quite literally in some cases.”

The new report goes on to explore how the healthcare community can support and educate patients on the importance of adhering to medication. GPs and pharmacists need to engage patients in a conversation and advise them of ways to help keep themselves on track in order to help tackle this nationwide health issue.

Heidi Wright, Practice & Policy Lead for England at the Royal Pharmaceutical Society concurs with this; “There’s a lot more that all healthcare professionals, including pharmacists, can do about having a proper conversation with patients on the benefits of different drugs.”

However, it’s not just communication that can help improve adherence, currently, nearly one million patients already use Adherence Packs in the UK, which are designed to enable the pharmacist or care provider to deliver personalised patient medication packs. Whilst the use of these products has risen over the years, it is recognised that there are still a large number of patients who find managing their medication a challenge and that some pharmacists, GPs and care agencies are still not aware of the aides which are widely available to support and encourage medication adherence.

Professor Ric Fordham, Professor of Applied Health and Economics, University of East Anglia interviewed for the report comments on the issue; “Non-adherence is a big problem.  When patients don’t feel ill they think there is no need for them to take their drugs any more. Or, if they start to feel better they arbitrarily decide they don’t need to take as much. But many of these patients have chronic diseases and will be on drugs for the rest of their lives.

He adds; “One part of the cost equation that’s often forgotten is what non-adherence does to the value of NHS drugs.  If patients don’t take their medication they don’t get the full benefit of them and that ends up reducing the cost effectiveness of the drugs – when NICE approves medicines it does so on the basis that they are used properly.  For example prescribing bisphosphonates for osteoporosis is relatively cheap but failure to adhere to these medications can result in a hip fracture which costs the NHS around £20,000 to treat – not to mention the impact on the patient’s quality of life.”

By highlighting the issue during a focused National Medication Adherence Week, Omnicell hope to bring together the healthcare community to work to start to address the issue. They are appealing to everyone to show their support for the adherence campaign by signing up to a pledge at: www.letstakecareofit.com/pledge  To find out more information visit www.letstakecareofit.com

References

‘The true cost of medication non-adherence’ report Sept 2015. Author Pat Hagan
Omnicell Medication Adherence: ComRes interviewed 2,048 British adults online between 31st July and 2nd August 2015. The sample of respondents was weighted to be nationally representative of all British adults aged 18+ by age, gender, region and social grade. ComRes is a member of the British Polling Council and abides by its rules. Full data tables are available at www.comres.co.uk.

1. www.gov.uk/government/news/action-on-medicine-wastage-and-improving-medicine-use
2. Medi-voice Project http://cordis.europa.eu
3. Diabetes in the UK 2010. Diabetes.org.uk

Since 1992, Omnicell (NASDAQ: OMCL) has been creating new efficiencies to improve patient care, anywhere it is delivered. Omnicell is a leading supplier of comprehensive automation and business analytics software for patient-centric medication and supply management across the entire health care continuum—from the acute care hospital setting to post-acute skilled nursing and long-term care facilities to the home.

More than 3,000 customers worldwide have utilized Omnicell Automation and Analytics solutions to increase operational efficiency, reduce errors, deliver actionable intelligence and improve patient safety. Omnicell Medication Adherence solutions, including its MTS Medication Technologies brand, provide innovative medication adherence packaging solutions to help reduce costly hospital readmissions. In addition, these solutions enable approximately 6,000 institutional and retail pharmacies worldwide to maintain high accuracy and quality standards in medication dispensing and administration while optimizing productivity and controlling costs.