Even the best care plan is useless if the patient doesn't stick to it. For one reason or another, many members fail to adhere to a complete treatment plan. They may miss medical appointments, skip lab tests, or not take their medication as prescribed. This can cause a severe detriment to their ability to combat chronic conditions or recover from a surgery.
In 2021, about 60% of adults took at least one prescription medication, with 36% reporting taking three or more. A study from the same year found that anywhere from 44.1% to 76.5% of adults don't take their medications as prescribed.
Medication adherence programs can help individuals stay on track with their medication routine and prevent unnecessary setbacks and complications that arise from not following treatment plans.
What Are Medication Adherence Programs?
Medication adherence programs are structured patient engagement strategies designed to help members take their medications as prescribed. The goal of a medication adherence program is to educate members about their treatment regimen, help them follow it consistently, and improve health outcomes.
Effective medication adherence plans improve patient well-being, reduce patient readmissions, and assist in meeting quality standards like Proportion of Days Covered (PDC).
Plans can be customized to address an individual's specific situation, taking into account health history, primary language, insurance coverage, and other social determinants of mental health. A combination of personalized support, financial assistance, and pharmacist involvement is a proven method for improving medication adherence.
The Scope of the Problem With Medication Nonadherence
At the most fundamental level, medication nonadherence presents an imminent health risk for the individual. members who don't take medications as directed don't receive their full benefits. This can result in increased symptoms, disease progression, reduced functional abilities, and increased risk of hospitalization or admission to long-term care facilities such as nursing homes.
Medication nonadherence can be particularly problematic for people with chronic health conditions. Research demonstrates that members with diabetes, hypertension, or congestive heart failure who were medication nonadherent were twice as likely to be hospitalized compared to the general population. In members with chronic obstructive pulmonary disease (COPD), research shows that poor medication adherence can lead to emergency hospitalization.
This increased need for advanced care has an economic toll. In 2016, the cumulative expense of nonadherence to prescription drugs was nearly $529 billion. The cost to members ranged from $5,271 to $52,341.
Foundational Strategies Used in Adherence Programs
To be truly effective, medication adherence programs should be customized to meet the needs of each patient. Most medication adherence programs rely on a combination of strategies, such as:
- Patient education
- Medication therapy management (MTM)
- Medication synchronization (med sync)
- Appointment-based models (ABM)
- Digital tools
- Financial assistance programs
Barriers That Prevent People From Staying on Track
Successful medication adherence programs address the root causes of nonadherence. Common reasons for not taking medications include:
- Forgetfulness
- Unpleasant side effects
- Difficulty affording medication
- Confusion about the prescription
Since people report different reasons for not taking medications as prescribed, it's essential to have a strategy that matches each individual's needs.
Smart Ways Technology Helps Support Adherence
Technology can play a key role in improving medication adherence. Digital medication adherence tools can adapt to accommodate an individual's comfort with technology and access to different types of devices.
- Apps: Apps for phones or tablets can send reminders, track different medication types (such as injections or eye drops), show photos of medications to make them easier to identify, and keep a medication history log.
- Smart pill boxes: Building on the tried-and-true analog pill organizers, smart pill boxes sync with an app, issuing a reminder if the patient misses a medication.
- Refill reminders: members can benefit from phone, email, or text reminders from a doctor's office or pharmacy.
- Telehealth: Virtual healthcare visits or communication via online platforms can make it easier for members to get answers about their medication without having to make an in-person appointment.
Behavioral Strategies and Personalized Support
Reminders and open lines of communication are powerful, but the key differentiator in medication adherence is building good habits. Personal accountability and a little positive reinforcement often outperform passive alerts.
User-friendly apps like Wellth can drive positive results with members who might otherwise not adhere to treatment plans. The Wellth app is an mHealth tool that encourages patient engagement with nudges to complete essential health tasks and prompts to upload a photo for quick AI verification. members can complete all tasks and verification without leaving the app.
Consistent task completion unlocks financial incentives, reinforcing long-term healthy habits. The Wellth approach boosts the Proportion of Days Covered (PDC) for people who were previously medication nonadherent. Users can apply their financial rewards toward groceries, gas, home repairs, and other essential costs.
Wellth: Making Adherence Programs Work Long-Term
The Wellth system offers proven results. Approximately 90% of Wellth users demonstrate plan adherence. This improves individual health outcomes while also reducing costs and easing pressure on the healthcare system.
Wellth users have a 43% average reduction in high-cost utilization, with an average 29% reduction in emergency room visits. Internal reporting shows that Wellth was able to reduce 90-day readmissions by 45% for members with post-acute coronary syndrome (ACS). In addition, using Wellth has resulted in a reduction of 1.29 in HbA1c among users with poorly controlled type 2 diabetes.
Wellth has a proven record of building medication adherence in at-risk populations to generate better health outcomes and reduce healthcare costs. Contact our team today to learn more about how Wellth can help members build good habits and improve medication adherence.
