What is medication adherence?
Medication adherence simply means sticking to your prescription. Adhering to medication is taking the medication as directed by a health care professional – whether taken in pill form, inhaled, injected, or applied topically.
Not taking medication as prescribed is called non-adherence. Many people never fill their prescriptions, or they may never pick up their filled prescriptions from the pharmacy. Other people bring their medication home, but don’t follow their health care professional’s instructions – they skip doses or stop taking the medicine.
Specifically, non-adherence includes:
- Not filling a new prescription or refilling an existing prescription when you are supposed to;
- Stopping a medicine before the instructions say you should;
- Taking more or less of the prescribed medicine; and
- Taking the medicine at the wrong time.
Why don’t people take their medicine as directed?
Taking medication correctly may seem like a simple or personal matter, but non-adherence is a complicated and common problem. Nearly three out of four Americans report that they do not always take their medicine as directed. There are many reasons why people are not able to take their medicines – including forgetfulness, lack of belief in the medicine’s effectiveness, being unsure the medicine is working, fear of side effects, trouble taking the medicine (especially with injections or inhalers) and cost of medicines.
Often there is no single reason someone does not take their medicine as directed, but rather a combination of reasons. One person may face different barriers at different times as he or she manages his or her condition. Whatever the reason, the result is always the same –patients miss out on life-saving benefits, a better quality of life, and lose protection against future illness or serious health complications. For instance, not keeping blood pressure in check can lead to heart disease, stroke, and kidney failure; not keeping diabetes under control can lead to amputation, blindness, and heart disease.
What if the cost of my medicine is a problem?
Cost of medicine, co-payments, and co-insurance are common reasons that some patients do not take their medicine as directed. Consumers should check with their health plans about their prescription drug coverage, and make sure they are getting the most out of it. They should also check with their healthcare provider or pharmacist about whether a medicine is available as a generic. Many pharmaceutical manufacturers have programs to help patients who need assistance paying for their prescription medicines.
Here are a few resources to assist with the cost of prescription drugs:
Benefits CheckUp: Prescription Drug Assistance
National Council on Aging website that helps seniors with limited income and resources make the best decisions about the public and private programs that are available to help them save money
on prescription drugs and other healthcare costs.
Helps underinsured people with life-threatening, chronic and rare diseases get the medications and treatment they need by paying for their out-of-pocket costs.
Partnership for Prescription Assistance
Programs around the country that help patients, caregivers and prescribers access free or low-cost prescription drugs.
Consumer Reports Best Buy Drugs
Consumers Union, the group that publishes Consumer Reports, picks the best drugs to treat certain conditions based on how well the drugs work, safety, side effects and cost. Also available in Spanish.
Some people with limited resources and income also are eligible for Extra Help to pay for the costs – monthly premiums, annual deductibles, and prescription co-payments – related to a Medicare prescription drug plan.
Why should I care about medication adherence?
Nearly half of Americans (133 million) are diagnosed with at least one long-term health condition, like asthma or diabetes. People with these common conditions take their medicine as directed only 50-60% of the time. It is likely you or someone you know has one of these conditions and is struggling to take their medicine as directed—and this can have serious health consequences.
Approximately 125,000 people die each year in the United States because of not taking medicine as directed. About one third of medicine-related hospital admissions in the United States are linked to non-adherence. Not only does it cost patients their health, but it also costs the country nearly $300 billion each year in additional costs for doctor visits, emergency room visits, hospital admissions and additional medicine.
Where can I get more information on medication adherence?
Please visit the Script Your Future Health Care Professional website for more information about the importance of medication adherence and how you can learn more. Basic background pieces include:
- World Health Organization (WHO) Report on Adherence
- National Community Pharmacists Association Medication Adherence in America: A NATIONAL REPORT
- National Council for Patient Information and Education (NCPIE) Medication Adherence National Adherence Action Agenda
What else do I need to know about taking and using medicines safely?
All medicines have risks and benefits. When a patient works with their health care professional to decide to use medicine to help manage a long-term health condition, he or she accepts certain risks in exchange for potential health benefits. Consumers can help manage those risks by using medicines safely, including storing and disposing of them safely.
Here are a few resources about safe medicine use :
- Food and Drug Administration (FDA) Safe Use Initiative
- National Council on Patient Information and Education (NCPIE) BE MEDWISE: Use your prescription medicines safely
- National Institutes of Health (NIH) Medline Plus
- Agency for Healthcare Research and Quality (AHRQ) Patient Safety Tools
- PhRMA’s My Old Meds Campaign
- FDA Information on Safe Disposal of Medicines
What can patients and family caregivers do if they have problems with medicine or questions about medication adherence?
If patients have any issues with their medicine that keep them from taking it as directed, they should start by talking to a doctor, pharmacist, nurse, nurse practitioner, or other health care professional to learn about options or tools that can help. They can also check ScriptYourFuture.org to find tools and resources to help.
Why do a whole campaign about medication adherence?
Nearly three out of four Americans report that they do not always take their medications as directed, leading to serious health consequences and avoidable costs. And as more and more Americans are affected by at least one chronic condition, the costs continue to grow. The total costs of non-adherence amount to at least $300 billion a year, including costs from medical complications and hospital readmissions. Our country needs a comprehensive, integrated campaign with cooperation from a variety of stakeholder groups to raise awareness of this critical health issue. Poor medication adherence is everyone’s problem – and it’s going to take a united effort to solve it.
What is the goal of the campaign?
The goal of Script Your Future is to raise awareness among consumers and their family caregivers about the importance of taking medication as prescribed as a vital first step toward better health outcomes. The campaign focuses on patients affected by three serious chronic conditions – diabetes, respiratory disease, and cardiovascular disease. It encourages patients and health care professionals to better communicate about ways to improve medication adherence.
What kind of campaign is Script Your Future?
Launched in May 2011, the Script Your Future campaign is a multi-year, research-based public education effort targeting consumers with chronic conditions, their family caregivers, and health care professionals. The effort includes coordinated national communications and targeted outreach in six state coalitions – Alabama, California, Maryland, North Carolina, Ohio, and Rhode Island – and additional states and areas targeted through the annual Medication Adherence Team Challenge. Public and private stakeholders help raise awareness by disseminating campaign messages through their networks.
What can health care professionals do about medication adherence?
If you are a health care professional (HCP) and would like help talking to your patients about taking their medications as prescribed, visit our HCP website and main web site at www.ScriptYourFuture.org to learn more about available campaign tools and resources, including journal articles on medication adherence and how it can be improved.
What can patients and caregivers do if they have problems with medications or questions about medication adherence?
If patients have any issues with their medicine that prevent them from taking it as prescribed, they should start by talking to a doctor, pharmacist, nurse, or other health care professional to learn about options or tools that can help. They can also visit www.ScriptYourFuture.org to find tools such as free medication reminders via text messages; sample questions to ask health care professionals; lists and charts to keep track of medicines; videos and fact sheets on targeted common chronic conditions, including diabetes, asthma, COPD, high blood pressure and high cholesterol.
What kind of research is there to back up this campaign?
Script Your Future was in the making for more than two years and is grounded in solid research on the issue of adherence. The National Consumers League conducted focus groups with patients and health care professionals on the barriers to adherence and a qualitative web survey to measure consumers’ knowledge of adherence as well as their adherence levels. In addition, a briefing paper on medication adherence in the United States was released at the launch. The briefing paper highlights the problem of non-adherence, the consequences of non-adherence, and the need for a campaign to encourage dialogue between health care providers and their patients regarding adherence.
Why is the National Consumers League leading this effort?
As America’s oldest consumer organization, the National Consumers League has advocated for consumer interests since 1899, providing government, businesses, and other organizations with the consumer’s perspective on a range of concerns – including medication information. From this position as an advocacy organization, NCL led the charge on organizing over 130 diverse stakeholders who reached consensus on a campaign plan. The National Consumers League continues to direct and lead the campaign, with ongoing input, guidance, and support from Committed Partners.
What will the campaign measure, and how will NCL know if it worked?
The Script Your Future campaign measured awareness of medication adherence – nationally and in the six target market cities. Greenberg Quinlan Rosner (GQR) surveyed patients in the campaign’s pilot cities before the campaign launched in 2011, at its midpoint in 2013 and again in 2015. The survey results, released in December 2015, demonstrate improvement in patient-provider communication and medication adherence, particularly in the campaign’s target market cities.
NCL will also look at the following:
Quantitative and qualitative communications metrics – including web analytics and media coverage
Committed Partner Engagement
Research and Data Partnerships as possible
Based on these metrics, NCL will continue to track how consumers have been exposed to the importance of medication adherence and communication with healthcare professionals in order to improve their health.
Where does the funding for the campaign come from?
NCL has brought together more than 130 public and private stakeholder organizations to develop and implement the campaign. To date, financial supporters include health care professional organizations, federal government agencies, pharmacists and pharmacies, patient groups and pharmaceutical companies.
Why does the campaign focus specifically on diabetes, respiratory disease and cardiovascular disease?
Seventy-five percent of health care spending goes toward care for people with chronic conditions. The importance of medication adherence can apply to any condition, but for this campaign we chose to focus on three chronic conditions where adherence is especially important to good health outcomes. Diabetes, respiratory disease (asthma and COPD) and cardiovascular disease (high blood pressure, high cholesterol and heart disease) are chronic conditions that affect millions of Americans and cost hundreds of millions of dollars every year to treat, but which also have an established medication component that can help prevent complications and future illness.
How will Script Your Future address the barrier of cost of prescription medicine? How can people be adherent if they can’t afford their prescriptions?
There are many reasons people do not take their medication as directed – and cost is certainly one of them. But from our research, which informed the Script Your Future campaign, cost is not the primary barrier. We did find, however, that conversations between health care professionals and patients are critically important, no matter why someone is choosing not to take prescribed medicine. That is why we are focused on raising public awareness about the issue of medication non-adherence and its consequences and encouraging dialogue between health care professionals and their patients. If people have questions about cost, we have provided links and tools on the campaign website www.ScriptYourFuture.org.
How can the campaign be both national in scope and focused in certain cites and states?
We know medication adherence is an important issue all over the country, so this campaign will involve a national survey and national media to raise awareness about adherence. We will also work with national partners, including health care organizations and practitioner groups, to share campaign messages and resources through their networks across the country.
Our efforts in specific cities and states will reflect the national messages while complementing existing local medication adherence efforts and providing additional supports, such as local coalitions committed to improving adherence. What we learn from our work on the local level can help inform and improve the national campaign.
How did NCL choose the cities for the campaign?
We used specific criteria determined by the campaign stakeholders to help identify cities where the campaign can have the greatest impact. These criteria included media market size, local prevalence of target chronic diseases, geographic diversity, demographic diversity, local presence of partner organizations, and local presence of other complementary efforts or organizations related to medication adherence. For our six initial cities, we chose Baltimore, MD; Birmingham, AL; Cincinnati, OH; Providence, RI; Raleigh, NC; and Sacramento, CA.
How can my organization get more involved in local campaign activities?
The first step to getting more involved in this campaign is to become a Committed Partner. If your organization is located in one of the six target states or in one of the states whose health profession schools are participating in the Team Challenge, NCL can connect you with the campaign contacts in your area to learn more about participating in specific campaign activities.
What does it mean to be a stakeholder or Committed Partner of the campaign? How do I become one?
Stakeholders are any organizations, agencies, and companies that have an interest in improving health and want to help improve medication adherence. Committed Partners are stakeholders that have officially signed on to demonstrate their support for the campaign, whether by contributing in-kind through participation in working groups, providing expert input, and/or supporting the campaign through financial contributions.
Campaign Partners also realize valuable benefits from their participation, such as helping to shape the campaign and gaining access to messaging and materials for distribution to their constituencies. If your organization is interested in joining the campaign, please contact NCL at email@example.com.
How will Script Your Future publicly recognize the campaign’s Committed Partners?
The National Consumers League relies on its Committed Partners to promote and extend the reach of the Script Your Future campaign – and we publicly acknowledge their participation in campaign materials and on our website.
How is the government involved in the campaign?
A number of government agencies have pledged their support for this campaign, and will assist NCL in advisory roles and by helping to disseminate adherence tools and resources. The Agency for Healthcare Research and Quality provided the initial planning funds for the campaign, and NCL also received a 3 year grant from the FDA. 18th U.S. Surgeon General Dr. Regina M. Benjamin was a keynote speaker at campaign events and made public service announcements for the campaign.
Is the campaign saying that medication is the only way to keep healthy? Shouldn’t this be about all the other things patients do to stay healthy?
No. We understand that medication is just one component of managing a chronic condition. That’s why the campaign puts the focus on the patient, rather than the medication. It’s also why the campaign messaging will always say that taking medication as directed is just part of managing a chronic condition.
However, this campaign is about medication adherence. The campaign goal is specifically about improving awareness about adherence, so we need to keep the focus on that aspect of chronic disease management. To try to address other aspects such as physical activity, healthy eating, etc., while important, will be confusing and dilute our message.