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Report: Multiple Strategies Help Patients Take Medicines

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A review of past studies of patients’ behavior in taking prescribed medicines shows a number of approaches and methods can encourage patients to adhere to their medication regimens. The report from RTI International and the Evidence-based Practice Center at University of North Carolina, and  funded by the Agency for Healthcare Research and Quality, appears online in the journal Annals of Internal Medicine.

The authors note that the problem of patients not taking prescribed medications is widespread. They cite studies showing 20 to 30 percent of medication prescriptions are never filled and about half of medications for chronic disease are not taken as prescribed. The problem is estimated to result in about 10 percent of hospitalizations in the U.S. and cause some 125,000 deaths.

The researchers reviewed 69 studies published from 1994 to June 2012 that assessed the effectiveness of interventions aimed at improving medication adherence for patients with various chronic conditions: high blood pressure, depression, high cholesterol, asthma, diabetes, heart failure, musculoskeletal diseases, heart attack, multiple sclerosis, and glaucoma. The studies covered low-cost, low-intensity approaches, such as one-time mailed reminders, to more complex interventions, including case management — planning and coordination of health care delivery — and collaborative care.

The findings show practices to reduce out-of-pocket expenses, such as reducing co-payments or improving coverage for prescription drugs, helped patients stick to their regimens. Other effective strategies in helping patients properly take their medications were better case management, patient education, and behavioral support.

Lead author Meera Viswanathan of RTI International says, “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.” Co-author Carol Golin, professor of medicine at UNC adds, “These findings also highlight the fact that policies that help patients afford to get their medication help them take their medication.”

The review was not able to pinpoint which interventions can be broadly applied, and the authors say more research is needed to understand what specific elements of the interventions are most successful.

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