Adhering to prescribed medications and treatment plans is essential to achieving positive health outcomes. According to the World Health Organization (WHO), improvements to medication adherence can have a more direct impact on patient outcomes than improvements to the specific treatments they are undertaking. This is why compliance is so important.
With that being said, despite the potential for negative consequences, around 50 percent of patients do not take their medications as prescribed for a variety of reasons. What are the consequences of medication non-adherence? We’ll fill you in.
What Are the Key Consequences of Non-Adherence?
- Worsening Health Conditions
A worsening health condition is one of the biggest consequences of medication non-adherence. Non-adherent patients—especially those with chronic conditions—tend to experience more symptoms, complications, and comorbidities. Over time, non-adherence can also cause more rapid disease progression, often resulting in a need for prolonged, intensive care.
- Increased Doctor and ED Visits
As a non-adherent patient’s condition worsens, their likelihood of visiting urgent care or an emergency department (ED) increases. Past studies show that nearly 8 percent of all ED visits are related to medication non-adherence.
This is not only stressful and inconvenient for patients—but also for the payers footing the bill. The cost of caring for ED super-utilizers is high: They represent only 3-5 percent of the U.S. population, but account for 30-50 percent of total ED spending.
- Prolonged Hospitalization
Hospital admissions associated with non-adherence are a common concern in healthcare. Poor medication adherence increases the risk of hospitalization—especially for patients with chronic conditions such as diabetes, heart failure, or coronary artery disease. Studies show that non-adherence accounts for up to 25 percent of hospitalizations in the U.S. each year, most of which could be prevented with a dedicated medication regimen.
- Adverse Effects and Mortality
Adverse effects and eventual mortality are the most severe consequences of non-adherence. Globally, approximately 275,000 patients die each year due to medication non-adherence, with around 125,000 of those deaths occurring in the U.S. This is a tough pill to swallow, so to speak, because in most cases, non-adherence deaths are both unfortunate and unnecessary.
How Does Non-Adherence Impact the Healthcare System?
Although the consequences of medication non-adherence impact patients and their families first, it’s also important to note the wider implications for the healthcare system as a whole. As non-adherence leads to worsening health conditions, an increased need for prolonged care, adverse effects, and potentially even mortality, healthcare utilization and costs go up across the entire system.
In fact, medication non-adherence is directly responsible for billions of dollars in unnecessary healthcare spending each year, with a recent study revealing that morbidity and mortality associated with non-optimized prescription drug regimens cost around $528.4 billion per year on average in the U.S., and non-adherence plays a significant part.
With so many severe consequences associated with non-adherence—some of which are quite literally life-and-death matters—it’s no wonder that clinicians, pharmacists, and payers are all highly motivated to improve adherence to prescribed medications and treatment plans. Fortunately, advancements in modern technology are empowering effective, efficient patient interventions to combat non-adherence that actually work. A large part is thanks to sophisticated targeting and predictive analytics.
Non-adherence is a persistent and problematic challenge with many unintended consequences. However, the right technology and program strategy can drive optimized medication adherence that minimizes consequences, reduces costs, and ultimately leads to the number one goal: improving patient outcomes.
About the Author
Dr. Linda Schultz
Dr. Linda Schultz is a results-oriented Healthcare Pharmacy Executive who excels at leading transformational, top-notch, interdisciplinary healthcare teams to create and execute outcomes driven clinical operations and account management initiatives. Dynamic and knowledgeable in all healthcare business segments, most passionately within the complex Medicare, Duals and Medicaid markets, she is an accomplished, creative motivator and driver of innovative quality and cost of care pharmacy interventions. Dr. Schultz is currently VP, Customer Success at AllazoHealth, a cutting-edge, healthcare artificial intelligence company. Prior to her leadership role at Allazo, Linda founded and led RxHorizons, LLC., an international healthcare consulting group. Her expertise stems from over 25 years of experience within the Managed Care industry, with a focus on leading, strategizing, developing and implementing pharmacy benefit management activities within national PBMs and health plans.