Can Digital Solve the Medication Non-Adherence Problem? Apple Thinks So
If you are reading this article, odds are you are taking medication for a chronic condition, such as pain, diabetes, or hypertension. Over 50% of US adults have at least one chronic condition, and over a quarter have multiple that they are managing. Unfortunately, medication adherence (or non-adherence as we will discuss) is extremely common in these patients, affecting nearly half who are prescribed treatment. This leads to over 125,000 preventable deaths each year and costs the industry an estimated $300 billion annually.
In this article, we will explain what medication non-adherence is, explore some of the causes, the cost and impact it has on the industry, and how digital tools (including the latest from Apple) are trying to solve the issue.
‘Drugs don’t work in patients who don’t take them’
(C. Everett Koop, MD, US Surgeon General, 1985)
What is Medication Non-Adherence?
Medication non-adherence is the intentional or unintentional act of not taking medications as prescribed by your physician. In one case, the patient is making a deliberate choice not to adhere, and in the other, it is driven largely by a lack of capacity or resources. It could mean not taking the medication at all, skipping dosages, or not taking it as prescribed. An example could be a sublingual that a patient just swallows instead of placing under their tongue for diffusion into the blood tissues.
Key Factors Driving Non-Adherence
Over the last few decades, numerous studies have examined the key factors leading to medication non-adherence. These include the following:
Forgetfulness. A large percentage of patients, around 42%, report that they simply forget to take their medications. They have all the intentions to take them, but after a few days of non-adherence, the habit never takes shape.
Cost. The average cost of prescription drugs for Americans is nearly $1,300, higher than anywhere in the world. While most of us have insurance to help pick up some percentage, many Americans are left to choose between medication and other financial priorities. This can lead to behavior such as not picking up or refilling a prescription or splitting pills to preserve and spread out their medication.
Fear. The potential for side effects is another reason most patients will not adhere to their medication. They are not willing to take the risk even if it is greatly outweighed by the therapeutic benefit of the medicine. Some fear is also derived from general mistrust by patients of their physicians and perception of pharmaceutical companies pushing them to prescribe their medication.