In a 2008 study in an adult managed care population, 39% of almost 11,000 participants were shown to be non-adherent with their AED treatment, defined as less than 80% adherence. AED non-adherence was significantly associated with:
- 48% increased risk of ER admission
- $260 in additional annual ER costs per person
- 11% increase risk of hospitalization
- $1799 in additional annual inpatient costs per person
- 44% increased risk of an unintentional injury due to a motor vehicle accident
Despite a reduction in prescription drug intake, a net increase of $1466 in total annual healthcare costs per patient remained due to this non-adherence.
A focus on improving adherence3
According to the American Medical Association, patients can often be reluctant to tell their physician that they are not regularly taking their treatment. It is essential to understand a patient’s medication-taking behavior to avoid unnecessarily escalating therapy, which can result in increased costs to the patient and health care system. Nonadherence may lead to unnecessary hospitalization and ER visits, further adding to total health care costs.
The AMA recommends these eight steps to improving medication adherence:
- Consider medication nonadherence as the first reason a patient’s illness is uncontrolled
- Develop a system to ask about medication adherence on a regular basis
- Create a supportive, blamefree environment when discussing medications with patients
- Identify why the patient is not taking their medication
- Respond with positive reinforcement to thank and encourage the patient for sharing information about their behavior
- Adapt adherence solutions to each patient’s specific needs
- Work with the patient to develop their treatment plan
- Set patients up for success with tools that make it easier to adhere to their medications
To learn more about these steps, please visit: https://www.stepsforward.org/Static/images/modules/14/downloadable
Promoting effective hospital discharge to curb readmissions2
After being discharged from the hospital, nearly half (49%) of patients experience at least 1 medical error in medication continuity, diagnostic workup, or test follow-up. It has also been reported that 19%-23% of patients suffer an adverse event, which is often drug-related and preventable. Typically, these errors occur due to a breakdown in communication during transition between the hospital team and primary care physician (PCP).
Recommendations to promote more effective care transitions at hospital discharge are summarized in the following table:
|Improving physician information transfer and continuity||
|Medication reconciliation and education||
|Providing adequate medical and social support||
|More effective physician-patient communication||
- Davis KL, Candrilli SD, Edin HM. Prevalence and cost of nonadherence with antiepileptic drugs in an adult managed care population. Epilepsia. 2008;49:446–454.
- Kripalani S, Jackson AT, Schnipper JL, Coleman, EA. Promoting effective transitions of care at hospital discharge: A review of key issues for hospitalists. J Hosp Med. 2007;2:314-323.
- Brown MT, Sinsky C. Medication Adherence: Improve the health of your patients and reduce overall health care costs. American Medical Association. 2015.