Bridging the Gap Between Prescriptions and Patient Action
For eight long years, my father grappled with chronic kidney disease. But it wasn't just the disease itself that he faced; he also struggled with medication non-adherence. At times, it became a perplexing puzzle: were we battling kidney disease or the struggle to adhere to prescribed medications? It felt like shouting into the void when the hospital handed him prescriptions—like barking at an unyielding wall. His commitment to strictly following the medication regimen was the missing piece in this intricate health puzzle.
Kampala, Uganda, Infectious Disease Institute, doctor discusses case in pediatric clinic. Credit: Lord R. / ©ILO/Richard Lord.
I saw him go through what I call the 4 phases of the medication non-adherence cycle.
Resistance to medication - bringing up the need to prescribe another
Increased healthcare costs - because he would need to purchase another set of medication
Hospitalization. The family was destabilized all the times my dad was hospitalized
Death
My father is among the three billion individuals worldwide living with chronic diseases. Half of these individuals do not adhere to their prescribed medication regimen, a neglect that contributes to 137 million deaths globally.
Medication adherence is an often overlooked yet crucial part of global health. More prominent issues frequently eclipse it. As we engage in discussions about groundbreaking medical advancements and the latest health trends, the issue of poor medication adherence patiently awaits its moment of recognition.
Medication adherence is a significant challenge in healthcare. Although it is universally recognized, it is often overlooked compared to more sensational issues such as infectious diseases. However, poor medication adherence is a silent crisis that has a profound impact on the lives of millions and strains healthcare systems worldwide. It is crucial to recognize it and take action against it.
When we think of medical progress, we often envision cutting-edge treatments and sophisticated interventions. However, the success of many of these advancements relies on patients’ adherence to prescribed medications. Unfortunately, many people who suffer from chronic diseases struggle with missed doses and unfilled prescriptions, which threaten their health and well-being.
Last year, my mother and I toured the Medical Ward at the Federal Medical Center in Abakaliki, Ebonyi State, Nigeria. Our mission was to better understand the challenges patients face with chronic diseases and, mainly, the primary reasons for their non-adherence to medication. The most common responses we received were that patients lacked sufficient funds to purchase their medications, were forgetful, were weary of constantly taking pills, and disliked consuming a large number of pills simultaneously.
Several strategies are currently employed to address the issue of medication non-adherence:
Traditional and Automated Pillboxes: While cost-effective, accessible, and easy to use, these tools have limited utility for individuals with complex medication regimens. They also fail to address more profound psychological barriers. Furthermore, there's no guarantee that the patient will ingest the medication after removing it from the pillbox.
Pharmacist-led Interventions: Pharmaceutical companies have attempted to combine drugs frequently used by chronic disease patients to reduce the number of necessary pills. While this approach somewhat addresses one cause of medication non-adherence, patients still struggle with adhering to the medication regimen.
Direct Observation Therapy: My lecturer shared a story about a group of tuberculosis patients who were closely monitored due to their blatant non-adherence to medication. These patients were provided with free drugs and were required to visit the hospital daily for supervised drug intake. Initially, this method seemed effective. However, the patients eventually grew weary and began missing their hospital visits. One missed session led to another until they dropped out of the program entirely. It was later discovered that some of the patients had begun selling the drugs they were given
Despite these challenges, there is hope. Incentivization and gamification have been proven to be effective strategies. Research indicates that these methods have improved medication adherence among people with chronic diseases by up to 20%.
Managing medication adherence can often feel like a game of chess, requiring strategy, planning, and the ability to adapt to unexpected challenges. But what if we could reframe this process as a game in which each dose taken represents a small victory?
This is why Medherence, a health-tech startup that uses gamification and incentivization to improve medication adherence and patient outcomes in people with chronic diseases, exists. While there may be skepticism about this approach, particularly given that most individuals with chronic diseases are aged between 45 and 64, it's important to remember that everyone appreciates recognition. The sense of fulfillment that comes from being rewarded can be a powerful motivator. When this feeling is paired with tangible incentives, individuals are more likely to adhere to their medication regimen. This creates a win-win situation: patients receive rewards and improve their health through medication adherence.
I propose that healthcare providers do more than prescribe medications to their patients. They should also introduce them to medication adherence programs. By integrating these programs into their practice, healthcare providers are not merely prescribing medications but fostering a collaborative and supportive environment that empowers individuals to take control of their health. These initiatives, which leverage the latest technology and personalized approaches, coupled with a dash of encouragement, can transform the often daunting task of medication adherence into a shared achievement. This approach could be particularly beneficial for individuals like my father, who struggle with medication non-adherence.
