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The Importance of Medication Adherence in Hospitals

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The roughly 50% of patients who do not take their medications as prescribed are putting their health at risk. Medication nonadherence can decrease the effectiveness of a treatment, which may lead to the worsening of a condition and possibly death.

While patients are primarily responsible for adhering to their regimen, hospitals should make supporting and helping improve adherence a priority. That's because patient medication non-adherence can have significant effects on a hospital's financial, clinical, and operational performance.

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Importance of Medication Adherence: 4 Key Reasons

Here are four reasons why hospitals should place a greater emphasis on the importance of medication adherence.

1. Responsibility to deliver quality care

An article published in the Annals of Internal Medicine estimates that medication non-adherence leads to nearly 125,000 deaths and 10 percent of hospitalizations. Hospital mission statements typically highlight a commitment to providing quality services and promoting wellness. Vital to successfully accomplishing both objectives is helping patients to properly follow their medication regimen.

The World Health Organization emphasizes the following: "Increasing the effectiveness of adherence interventions may have a far greater impact on the health of the population than any improvement in specific medical treatments." Hospitals must embrace the significant role they play in helping with medication adherence. A critical step is recognizing and working to address medication adherence issues that follow a hospital stay.

As a Managed Healthcare Executive article notes, "During the hospital stay, standard medication routines are interrupted and upon discharge, existing medications may be discontinued and new prescriptions written. In the transition from hospital to home, scripts for new prescriptions may never make it to the pharmacy or if they are transmitted electronically, patients fail to pick them up."

2. Reduction in admissions and readmissions

Statistics show that 33-69% of all medication-related hospitalizations that occur in the United States are the result of medication non-adherence, as noted in a Patient Preference and Adherence article. And a 2017 study, also published in Patient Preference and Adherence, determined that patients with low and intermediate adherence (combined) had readmission rates of 20% compared to a readmission rate of slightly over 9% for patients with high adherence.

As a 2017 report from the National Quality Forum notes, "Reducing unnecessary hospital admissions and readmissions is a key component of health care quality improvement. High rates of readmissions are costly to the health care system and can indicate low-quality care during a hospital stay and poor-quality care coordination."

Improving care quality isn't the only reason to drive down admission and readmissions rates. With federal and private payers increasingly focusing on value-based care and population health management, hospitals that can reduce their admissions and readmissions may receive financial rewards and/or avoid reimbursement penalties.

3. Cost savings

With hospitals spending more and often being paid less for services, identifying cost savings opportunities is essential to long-term sustainability. Improving medication adherence represents one such opportunity — and a great one at that. As the Annals of Internal Medicinearticle referenced earlier notes, medication non-adherence costs the health care system between $100–$289 billion annually, with the CVS Health Institute noting that hospital readmissions account for about $41 billion of the total costs. 

A study published in the American Journal of Managed Care (AJMC) found that the health care industry may achieve savings of up to $37 for every additional dollar spent on improved medication adherence. Another AJMC article noted that for each 1% increase in adherence among 1,000 patients with diabetes 65 years and older, an all-cause cost savings of more than $65,000 was achieved over three years. These and other statistics show there is a potentially significant return on investment that can be achieved by undertaking efforts to improve medication adherence.

4. Patient satisfaction

As health care continues to shift toward patient-centered models, with patients becoming more active participants in their care and the decisions concerning it, patient satisfaction has taken on a much greater importance.

An American Academy of Emergency Medicine article notes, "Hospitals need to show the community that they are interested in quality care, and they need to find ways to improve in order to remain competitive. Patients are our customers, and as customers, they have the right to choose where to go for their medical care. Patients are easier to serve if they feel their needs are being met. This results in happier staff and patients. Conversely, when patients' needs are not met, we often hear about it through angry letters, poor satisfaction scores or sometimes publicly in local papers."

A hospital's efforts to help its patients achieve and maintain adherence can have a significant impact on satisfaction. If these efforts are successful, with patients leaving the hospital understanding why changes were made to their medication regimen, knowing how to follow the new regimen, and feeling like their questions and concerns were addressed, satisfaction should increase or at least not decrease.

But if patients leave a hospital confused about why changes were made to their regimen, unsure how to properly follow a regimen, and believe their questions, concerns, and personal needs were not addressed effectively, satisfaction will likely decrease. Satisfaction could sink further if patients experience a medication-related health issue, potentially one requiring readmission.

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