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To improve patient adherence, we first need to puncture some myths

By Katrina S. Firlik MD on Oct 5, 2011

The following are the top five myths I encounter regarding medication adherence—or the lack thereof—based on my experience as co-founder and chief medical officer of a start-up in the space.

1.    Medication non-adherence is mainly a problem for conditions like hyperlipidemia.

Wrong. Medication non-adherence crops up in nearly every condition and therapeutic class, from acne to oncology. People lose transplanted organs due to failure to stick with immunosuppressant medications. People with glaucoma go blind because they don’t administer their drops faithfully.

2.    Medication non-adherence primarily affects the poor and undereducated.

Wrong. There is no clear demographic for medication non-adherence. It can affect the CEO of a company, or the part-time janitor, although potentially for different reasons. Many papers have been published on the topic, and although trends may be noted in one paper or another, there is no clear consensus (other than that older people are typically more compliant, simply because they are very experienced pill takers).

3.    Simple forgetfulness is a primary driver of medication non-adherence.

Wrong. Although forgetfulness is certainly the most common reason that an otherwise diligent person may accidentally miss a dose here and there, that is more of a sidebar and not at the heart of the serious adherence problem. The real problem is that people stop refilling their medication altogether. It’s a persistence problem. Simple forgetfulness is not the reason that a person calls it quits.

4.    Physicians should play the major role in driving medication adherence.

Wrong. Although physicians absolutely should encourage adherence as much as they can within a 15-minute time slot filled with other priorities, their role is fundamentally limited. How often do you see your doctor? It’s hard to be the primary motivator of an important daily routine on an annual basis. Physicians can only do so much. 

5.    Medication non-adherence can largely be solved by the diligent and widespread application of rational solutions, like cost reductions, reminders, and education.

Wrong. Medication non-adherence is largely rooted in human irrationality. Wouldn’t it be great if education alone could be the silver bullet? Or free medication? (Look at European countries with no out-of-pocket pharmacy costs—they have the same adherence problem!) Or reminder systems like text messages, e-mails, phone calls, and cool devices? All nice-to-haves, but not enough.

Katrina S. Firlik, MD, is co-founder and chief medical officer of HealthPrize Technologies, LLC. Prior to HealthPrize, she was a practicing neurosurgeon in Connecticut. She is also the author of Another Day in the Frontal Lobe: A Brain Surgeon Exposes Life on the Inside.

For everything tech- and patient-related, join the industry’s other key players at Patient Adherence, Communication and Engagement (PACE) USA on October 24-25 in Philadelphia. Download the full PACE agenda and speaker line-up here. Want to know more? Contact laura@eyeforpharma.com.

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