Going off your meds is costly — and deadly

(Text and images from Australian Financial Review)

Prescribe medication to people living with a chronic disease, and there’s a 50–50 chance they’ll be off their medications within a year.

People who don’t adhere to their prescriptions not only have poorer health outcomes, they also place a massive $650 billion burden on the healthcare system.

Let’s be clear about what poorer health outcomes mean: ultimately, non-adherence can kill people.

Research conducted in the US shows around 120,000 people die every year as a result of not taking their prescription medicines as directed, otherwise known as ‘‘medication misadventure’’, says MedAdvisor executive director and CEO Robert Read.

‘‘If you translate that to an Australian context based on population, it would be the equivalent of a 747 crashing every two weeks,’’ Read says.

‘‘We need to shine the spotlight on medication adherence so we can improve health and reduce costs.’’

Another 2005 US study of more than 1000 patients with stable coronary artery disease showed those taking medication at less than 75 per cent of the prescribed rate were 4.4 times more likely to have suffered a stroke after four years, and 3.8 times more likely to die.

That’s after allowing for a range of factors including smoking and age.

The findings for this US report are consistent with the results of an Australian study of more than 4000 older patients with high blood pressure, says consultant cardiologist and health media commentator Dr Ross Walker.

‘‘Adherent patients were 29 per cent less likely to experience a fatal cardiovascular event and 42 per cent less likely to experience heart failure,’’ he says.

In 2003, the World Health Organisation found that low- cost interventions to improve adherence to medication resulted in significant cost savings in healthcare systems.

So how can we get patients to stick to their medication? The recommendation from WHO is simple: ‘‘Patients need to be supported, not blamed’’. One of the best ways to support patients is to remind them when it’s time to take their medication.

It could be as simple as a text message.

A report analysing the results of 16 separate studies across 12 countries, published last year in the Journal of the American Medical Association, found that a text message reminder increases adherence, at least over the short term.

MedAdvisor has gone one step further. The Australian company has created an app that makes managing prescription medication and doctors’ appointments less disruptive for patients. The app is available on PC, tablet and smart phone.

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‘‘We’ve analysed de-identified dispense data for 11 highly prescribed chronic medications across 1.3 million patients who weren’t using MedAdvisor and we found the average adherence across these 11 medications was only 54 per cent,’’ Read says. In comparison, figures show users of MedAdvisor achieve adherence rates of about 66 per cent, which means they were about 22 per cent more likely to be compliant with their doctor’s instructions than other patients. ‘‘But also what we’ve done is look at our users, before and after using MedAdvisor, and that’s a similar number — it’s about 21 per cent from the 12 months prior to the 12 months post,’’ Read says.

The MedAdvisor app is free to users and is offered by and paid for by pharmacies who are rewarded by increased revenue and customer loyalty.

MedAdvisor reminds users when to take their medication, how much to take, how many days of supply they have on hand, how many script repeats they have remaining and gives prompts to renew prescriptions before they run out.

The app is linked to the local pharmacy so data is updated automatically as the prescriptions are first.

We need to shine the spotlight on medication adherence so we can improve health and reduce costs.

MedAdvisor executive director and CEO Robert Read filled. The app can also be set to remind users — either by pop-up smart phone notifications or by email if users don’t have one — when to take and when to stock up on vitamins and other non- prescription supplements.

One of the most loved features is ‘‘Tap-to-Refill’’, which allows users with a tap of a button to order medications ahead, eliminating tedious waiting times at the pharmacy.

The app can link in a patient’s GP, so they can request repeat prescriptions and provide their doctor with important updates about their medications.

MedAdvisor also provides comprehensive information about each medication, including how to take it and what potential side-effects to be aware of.

Carers, including spouses and children, can with consent, add other people to their accounts to help them manage their medications.

It’s all about giving patients and their carers control over their medication.

‘‘Educating and empowering the patient must be central to any strategy because ultimately it is the patient who will decide whether or not they will take their medications as prescribed,’’ Walker says.

MedAdvisor, which Read says boasts a 4.6 app store rating, goes a long way in bridging the gap and reducing the health burden medication misadventure causes.

‘‘There are more than 800,000 patients who are already connected to MedAdvisor,’’ Read says.

‘‘But with 50 per cent of Australians living with a chronic disease, there is still so much opportunity to get the app into the hands of more and more people.’’

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Written by

Dr Walker is an expert in the field of preventative cardiology and has published seven books. He gives lectures nationally and internationally.

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