Non-adherence costing €125 billion and responsible for 200,000 deaths in the EU annually1
A new report into non-adherence to medicines has been published today by Pfizer Healthcare Ireland in association with the Irish Pharmacy Union (IPU) and the Irish Patients’ Association (IPA). The report, titled ‘A Report on Patient Non-Adherence in Ireland’ reviews existing international literature on medication adherence and outlines results from an Irish survey examining adherence in Ireland and the factors which hinder it and promote it.
The issue of non-adherence is of growing concern to clinicians, healthcare systems, and payers because of its negative effect on health outcomes as well as contribution to higher costs of care and its impact on productivity. Further data indicates that medication non-adherence is costing EU governments an estimated €125 billion and contributing to the premature deaths of nearly 200,000 Europeans annually1.
Today’s report reveals the results of an Irish survey which captures the extent of patient non-adherence in Ireland. According to the research;
– Non-intentional non-adherence is significantly more common that intentional non-adherence with ‘forgetfulness’ the main reason patients report for missing their medication (71%)2. Other reasons patients are intentionally non-adherent include patient perception that they don’t need the medication any more (20%); they feel better (16%); they are anxious about the side effects (5%) or they don’t believe that the medication was effective (4%)2.
– Of the conditions requiring regular medication, patients with asthma, diabetes and high cholesterol reported the lowest levels of adherence (30% in people with high cholesterol and 31% in people with asthma or diabetes)2.
– 52% of carers said that the person they care for regularly forgets to take their medication2.
– The three factors ranked most important in ensuring people do take their medication are talking regularly to the doctor (74%); having a good understanding of the illness (42%); and having a good understanding of the medication (40%)2.
– Patients who were reviewed by healthcare professionals within the last month tended to be more adherent to their treatment than patients who had longer time intervals between reviews2.
– 18% of those surveyed reported they are not fully adherent all of the time2. This rises to 23% in men, and also 23% in those under 352.
– Of those who sometimes miss their medication, 64% miss it one or more times a week2.
– Those who are non-adherent are significantly more likely to have two or more conditions2.
Speaking about the launch of the report, Mr. Stephen McMahon, CEO of the Irish Patients’ Association said “This report is another step forward in patient safety by making us aware of the level that Irish patients do not adhere to their prescription medication regimes. It is evident that all those involved with the patient i.e. the doctor, the pharmacist, the nurse, the payer, the policy maker and the manufacturer, should play a role in promoting the importance of adhering to prescribed medication. As a patient advocate with a passion for embedding a culture of patient safety everywhere, my call to action to patients is: Take your medicines as advised. And to healthcare professionals at every opportunity ask your patients “Have you taken your medicines today?”
The survey found that the most common barriers to adherence are the perception that the medication does not make a difference (44%) or that their treatment will not prevent further deterioration of their condition (39%) both of which can be addressed by appropriate patient education2. The report recommends that regular patient review might be required for some patient populations more than others and in some disease areas more than others to improve adherence.
The report also highlights the important role that healthcare professionals play in promoting and maintaining patient adherence. Also commenting on the report, Mr. Rory O’Donnell, President of the IPU said “Pharmacists are among the most accessible and most consulted healthcare professionals and are therefore ideally placed to tackle non-adherence to medication, by educating patients, helping them make informed decisions about their medicines and supporting them in adhering to their prescribed therapy, thus ensuring that, by taking the right medicines in the right way at the right time, patients achieve the optimum benefit.”
A number of recommendations to help improve adherence levels among Irish patients are outlined in the report. These include personalised interventions to overcome non-adherence, access to training for healthcare professionals, a collaborative approach involving the patient in their health management and increasing the use of memory aids to help patients increase adherence. According to the survey, 76% of Irish patients claim to have no formal method or system to help them monitor or remind them to take their medicines2.
Mr. Paul Reid, Managing Director of Pfizer Healthcare Ireland said “The issues surrounding patient adherence are complex and varied, with psychological, social and economic factors all playing a role. However research has shown that effective strategies to improve adherence can be successful, resulting in better health outcomes for patients and reduced waste in terms of costs as well as actual medicines. Because it is largely avoidable, we hope that this report will help inform and educate the myriad of stakeholders in the healthcare sector of the importance of patient adherence in the hope that steps will be taken to address the issue.”
Download the full report here Medication Adherence Report
1. European Council Policy Makers Debate. An EU response to medication non-adherence. Brussels, 2010.
2. Behaviour & Attitudes Ltd. Patient Adherence – Quantitative & Qualitative Research. July 2013.