Want to enhance medication adherence? Make it fun

*Katrina S. Firlik, MD, argues that adherence may do more to improve health and decrease costs than the development of new medications*

By Katrina S. Firlik MD on Oct 27, 2010

Katrina S. Firlik, MD, argues that adherence may do more to improve health and decrease costs than the development of new medications

As a neurosurgeon, I often treated patients who had suffered spontaneous cerebral hemorrhagesbleeding in the brain.

A number of these hemorrhages, particularly those deep within the brain and not amenable to surgery, were related to long-standing hypertension.

However, a number of patients with these hypertension-related hemorrhages had been poorly compliant with their medication over the years, or had taken themselves off of their anti-hypertensive medication altogether.

In the throes of my clinical practice, I didnt have much time to ponder the tragedy of these cases.

I had a job to doto prevent an acute re-bleed and to protect the remaining healthy brain.

I was working at the end of the linecure rather than preventionbut in a scenario where there really wasnt a cure, per se, but instead only lengthy supportive care. Depressing.

Better than cure

I know that prevention isnt easy.

Similar to other healthy behaviors, like weight loss and exercise, medication adherence is all about motivation and sustained behavior change.

So how do you encourage patients to stick with their medications to keep their blood pressure or cholesterol in the normal range, or to prevent cancer recurrence, or evenbelieve it or notto prevent organ transplant rejection?

(Poor adherence is a leading cause of rejection.)

I believe that in order to improve adherence over the long term, which is the name of the game when it comes to managing chronic disease, you need to:

  • Fundamentally enhance the value proposition for the patient: Many patients claim forgetfulness or cost as their knee-jerk reason for non-adherence when, in reality, the true problem is a value problem; they dont adequately value their medication for one reason or another.
  • Target the right patients: Theres little ROI or clinical benefit in preaching to the choir by attracting only the patients who are already adherent and engaged in their health.
  • Engage patients in ways they actually want to be engaged: This may mean trying a fun approach (not a word often used in healthcare) that appeals to the consumer rather than to the patient.

Fortunately, in my recent experience and exchanges with those close to this issue, improving medication adherence is becoming more of a priority for the pharmaceutical industry.
I believe this focus may very well do more to improve health, prevent complications, save lives, and decrease healthcare costs than will the development of new medications.
Its a lofty goal that is potentially fraught with many obstacles, but, in my opinion, its a win-win for everyone involved.

Katrina S. Firlik, MD, is co-founder and chief medical officer of HealthPrize Technologies, LLC (www.HealthPrize.com). 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.