Our team recently ran across these interesting medication adherence statistics, all of which have implications for physicians, hospitals, and of course, patients. Keep reading for more on this medication adherence research.
1. 55% of Americans regularly take a prescribed medication.
Which, according to a recent Consumer Reports survey, is more prescribed medications than ever before.
Data from the report show that the number of prescriptions filled from 1997 to 2016 increased by 85% while the total population increased by 21%. Those who take prescriptions, on average, take four of them. Not surprisingly, 40% of people aged 65 and older take five drugs or more, which qualifies them as “polypharmacy” patients.
2. 53% of Americans who take prescription medications say they get them from more than one health care provider.
Which drives the opportunity for adverse drug events (ADEs).
Further, the Consumer Reports survey found that more than a third of respondents say no provider has reviewed their medicines to see if all are necessary. With so many people on so many meds, it’s more important than ever to conduct an effective medication reconciliation at every encounter. What is your healthcare organization doing to regularly assess the consistency and effectiveness of this process?
3. The number of medicines a patient is taking is the single most important predictor of medicine-related harm.
Studies indicate that the more medicines a person takes, the greater the risk of an adverse drug reaction, a drug-drug interaction, a drug-disease interaction, cascade prescribing (where more medicines are added to counteract side effects of existing medicines), non-adherence, and drug errors (wrong drug, wrong dose, missed doses, erroneous dosing frequency). [1]
4. Over the past decade, the prevalence of polypharmacy in the US adult population has doubled.
The number of people taking 5 or more medicines went from 8.2% in 1999–2000 to 15% in 2011–2012.
Certainly there is benefit from many of these medications. But when polypharmacy is inappropriate, especially in older people, there is increased opportunity for ADEs, ill health, disability, hospitalization and even death. In fact, approximately 1 in 5 medicines commonly used in older people may be inappropriate, rising to a third among those living in residential aged care facilities.[2]
Many physicians and healthcare organizations have begun to look at ways to deprescribe - a process of systematically reviewing, identifying, and discontinuing potentially inappropriate medicines to improve outcomes.[3] The Institute of Healthcare Improvement (IHI), for example, is leading a collaborative effort with Ascension Health and Kaiser Permanente to test and adapt best practices for deprescribing. The initiative is inspired by a project led by the Bruyère Research Institute in Ottawa, Canada.
5. The US consumes 80% of the world’s prescription painkiller supply, despite not even making up 5% of the world’s population.
The articles and information about our nation's opioid crisis are abundant. I'm not going to duplicate what you probably already know or have read in other news media. But this stat really illustrates the enormous size of the problem our healthcare system is facing.[4]
6. People with four or more ER visits in the past year were 48 times more likely to die of prescription drug overdose compared to those who visited an ER once or not at all.
This statistic is as startling as it is unsettling.[5] The lesson that hospitals can learn from it is the importance of looking at patient usage patterns and identifying those who need intervention or referral to a physician or facility that can treat the underlying issue and potentially decrease or eliminate their return visits.
This same study showed that the risk of death from prescription drug overdose was highest among patients with substance abuse disorders or other psychiatric disorders, men, whites and those aged 35 to 54, and those who were more likely to have been discharged against initial medical advice at the initial ER visit.
7. Telehealth physicians score higher with patients when they prescribe antibiotics.
A recent study published in JAMA Internal Medicine found that patients who sought telehealth care for a respiratory tract infection such as a common cold rated themselves happiest with their doctor’s visit when they closed the app having received a script for antibiotics. This is regardless whether the drug was needed or not.
Not such good news for antibiotic resistance efforts.The study found that 66% of patients seen in a telemedicine visit received antibiotics for respiratory tract infections.
8. Vicodin usage rates in 12th graders have declined from 9.6% in 2002 to 2% in 2017 in 12th graders.
I thought I'd end with a bit of good news. Vicadin as well as misuse of all prescription opioids has dropped dramatically in 12th graders, according to the 2017 Monitoring the Future annual survey from the National Institute on Drug Abuse. This despite the meteoric rise of opioid use in adults.
It should be noted, however, that in this same survey 12th graders also reported the following rates of non-prescribed use of these top three prescription drugs: Adderall (5.5%), tranquilizers (4.7%) and prescription opioids (4.2%).
[1] Evidence-Based Deprescribing: Reversing the Tide of Potentially Inappropriate Polypharmacy. Journal of Clinical Outcomes Management. 2016 August;23(8), Ian A. Scott, MBBS, FRACP, MHA, MEd, Kristen Anderson, BPharm, AACPA, Christopher Freeman, BPharm, GDipClinPharm, PhD, AACPA, BCACP. https://www.mdedge.com/jcomjournal/article/146251/drug-therapy/evidence-based-deprescribing-reversing-tide-potentially#
[2] Ibid.
[3] Ibid.
[4] American Society of Interventional Pain Physicians. (2011). The American Society of Interventional Pain Physicians (ASIPP) Fact Sheet
[5]https://consumer.healthday.com/general-health-information-16/drug-abuse-news-210/multiple-er-visits-linked-to-risk-of-prescription-drug-overdose-death-699347.html
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