Medicine non-adherence- effects and consequences on health

By Sanjana Rao, Ph.D.

Medication non-adherence (when patients don’t take their medications as prescribed) is fairly common, especially among patients with a chronic condition. This happens to be one of the primary determinants of a treatment's success. Medication non-adherence has been consistently associated with worsening clinical outcomes, higher re-hospitalization rates and a higher use of resources. Despite the healthcare-providers’ efforts to convey the importance of the medications they prescribe, patients have many intentional and/or unintentional reasons for deviating from the treatment plan.

The most common factors associated with non-adherence include forgetfulness (50%), having other medications to take (20%), and being symptom-free (20%). In these cases, their condition can get worse which could have serious consequences on their health, not to mention the economic costs.

Studies have shown that about 40% of patients on a short course of antibiotic therapy are non-adherent. This kind of deviation can lead to re-infection and also serious consequences with the development of bacterial resistance.

How many times has it happened- the doctor has given you specific instructions on how to take a particular medication? Have you ever wondered why? This is also true for over-the-counter medications - for maximum effectiveness- medicines should be taken as directed by your healthcare professional.

For example, ibuprofen is best taken with food as otherwise it causes stomach irritation and some other drugs are more effective on an empty stomach which usually means at least an hour before a meal, and at least 2 hours after one. If you are supposed to take medicines without food, it may be because the chemical compound easily degrades in an acidic stomach environment. Apart from this, taking medication at a consistent time everyday is highly advised.

In the US alone, medication non-adherence leads to 125,000 preventable deaths each year, and about $300 billion in avoidable healthcare costs. In developing countries, the estimated amount of non-adherence is even higher than 50%.

Physicians tend to overestimate how well patients take their medication as prescribed. This can lead to missed opportunities to change medications, solve adverse effects, or propose the use of reminders in order to improve patients' adherence. Thus, providing physicians with feedback on medication adherence has the potential to prompt changes that improve their patients' adherence to prescribed medications.

Increasing adherence via digital health tools

Digital health tools such as mobile apps can provide patients with comprehensive solution which combines education, builds motivation, provides support and monitors how a patient manages medication. Technology can also be used to promote medical adherence via smart pill boxes where sensors in the bottle cap that detect when a bottle is opened or through sensors in the bottom of the bottle that can identify the weight of the pills and calculate if the patient was adherent. Another method to promote adherence is through smart package systems where sound cues alert a patient to take their pills. Apart from this there are also ingestible sensor technology, where alerts are sent to a patient’s on their smartphone and in some cases physicians.

However, technology alone is not a solution to solve the adherence problem- a behavior change is required. On the patient side, it is important for them to understand the importance of sticking to a medication regimen which will in turn make them use the digital technology of choice optimally.

* Please consult a medical professional before taking prescription or other medication*

With our Health management app, Miyara, we want to empower you to make good decisions for you and your family- with medicine and disease information, pill reminders and as well as the ability to upload, file, save medical records in just a few clicks.

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