Medication adherence is a complex issue that impacts the entire healthcare industry. Patients fail to take their medications as prescribed for many reasons, and the consequences are often significant.
To improve medication adherence, it’s essential to have a solid understanding of the factors that influence it. We’ll break them down for you:
Condition-related factors—such as symptoms and severity—can impact medication adherence. In many cases, a chronic condition starts as a silent disease with little-to-no obvious side effects for months or even years.
This can lead to patients being more reactive than proactive, waiting to see adverse effects before adhering to prescribed medications. For example, someone with high cholesterol might be non-adherent until they begin seeing clinical signs of heart disease.
Socioeconomic factors greatly influence medication adherence. The social determinants of health (SDOH)—meaning factors related to where patients work, live, and interact—can profoundly impact their ability to adhere to treatments. The cost of medication is a massive barrier to adherence for socially vulnerable patients, especially amid rising drug costs. This is particularly true for high-tier, branded medications and specialty drugs for chronic conditions that don’t have generic alternatives.
Access to a pharmacy or provider also plays a role in whether or not patients are adherent. For some—especially older patients or those in more rural areas—accessing medications and educational resources is very challenging. This not only impacts medication fill rates, but also health literacy and overall understanding of a specific condition or treatment.
Medication-related factors also come into play. The type of medication matters; patients are more likely to be adherent to oral medications than to other formats, such as injections. The total number of medications a patient is prescribed—and how many times a day they’re supposed to take it—can impede adherence as well. Supply is another notable factor, as patients with a 90-day supply are more likely to be adherent than those who need to refill medications every few weeks.
Side effects are another significant medication-related factor that can influence adherence. For example, some patients begin taking medication with initial side effects that may taper off as they adjust, but secede therapy before that day comes. Others may have more lasting side effects that can only be prevented with additional medications. Whatever the case is, there’s a good chance unpleasant side effects will impact adherence.
Finally, there are the behavioral factors. For instance, inherent motivation and commitment to prioritize health and take medications as prescribed can significantly impact whether a patient is adherent. The inverse is true as well—when patients are unmotivated or noncommittal.
In some cases, something as obvious as forgetfulness or absentmindedness can get in the way of medication adherence. Mental health issues, such as depression and anxiety, can also play a part—especially when it comes to adherence to antidepressants or other behavioral medications.
Last but not least, denial and acceptance influence adherence. When a patient is in denial about needing medication—or maybe that they even have a condition to treat at all—they’re far less likely to follow their prescriber’s instructions. This can come full circle back to condition-related factors, as denial can stem from a lack of visible symptoms.
These are only some of the more common factors that influence medication adherence. Many other factors, some very specific to each person’s unique situation, can impact whether a patient takes their medications. At the end of the day, honing in on what those factors are is key to addressing them, making improvements, and achieving better health outcomes for each individual.