The Answer to Patient Adherence is Not One Solution, But Many...

Non-adherence to treatment is a growing, multi-faceted problem meaning that a long-term, collaborative healthcare industry effort to develop a variety of rather than singular compliance solutions is the best way forward.

Earlier this month, a study published in the Annals of Medicine which reviewed several US studies on an individual’s ability to adhere to their prescriptions, showed that lowering drug costs should improve a patient’s compliance to their medication. However, most of these studies have not monitored the effectiveness of cost for patient adherence in the long-term meaning that other patient education or behavioural solutions for compliance could also be viable options. Therefore, the question of how to improve patient adherence in the real world still exists.

As stated in my previous articles, building and sustaining relationships with patients and other health stakeholders is essential for the pharmaceutical industry and this would be my ideal, continuing solution for improving adherence levels. Recent findings from a Cap Gemini report demonstrate that most of the commonly adopted adherence interventions had moderate success and no single intervention strategy has been effective. This research has shown that the rarely used approaches like nurse educator schemes and pharmacist programmes are most popular but the report states that the costs related to personal interaction has prohibited adoption. Additionally, interviewees who included pharma executives, payers, pharmacists and patient associations from US and Europe, stated that the lack of a long-term strategy or continuity, poor understanding of a patient’s needs and several programmes by different stakeholders running in isolation meant that adherence success was hindered.

An evolution of the healthcare industry means that it is not just providers but also pharmacists and nurses who can collaborate together to shape patient behaviour. If patients do not trust the treatment prescribed or are not motivated to stay on course in the long-term, nurses can use patient or motivational interviewing techniques, to move past these barriers. Nurses could coach the patient to change their non-adherent behaviour gradually and then discover a better understanding of their needs which would be very useful for the pharmaceutical industry and doctors, who are often hindered by time constraints. Once an initial understanding of needs is discovered earlier in the drug treatment process, healthcare stakeholders could determine other sources of secondary data to improve the patient journey. Pharma could develop communication strategies for nurses while working with other stakeholders like pharmacists to develop plans for medication therapy management and home visits, which would also offer a helping hand to doctors.

Furthermore, pharmaceutical companies could develop a better partnership with patients by empowering them through the social media space to manage their own healthcare. The pharmaceutical industry have a duty to ensure that accurate health information is part of the online conversation and so could provide resources to help doctors and other healthcare stakeholders to interact with patients who are unsure about complying or adhering to a particular treatment. This initial sharing of information by companies could encourage patients to share their personal adherence problems which are real world data that could be used to develop more patient-centred treatment programmes. Moreover, the industry could use this space to initiate holistic treatment ideas to help patients live a good quality of life after diagnosis. In addition, pharmaceutical companies can collaborate further with payers to ensure a lower cost for drugs as well as work with governments and employers to increase the uptake and the development of adherence initiatives.

All in all, there is no single adherence solution that will meet every patient’s individual needs. A selection of collaborative solutions to adherence must be developed by all in the healthcare industry and then applied depending on the type of patients. It goes without saying that healthcare stakeholders who are currently implementing adherence standalone solutions could ensure better outcomes if all players were equally engaged in ensuring its success. The pharmaceutical industry needs to start facilitating this cohesive approach so that one day, the current $30 billion lost in non-adherence annually can be used to develop a thoroughly innovative, patient-centred service that is open to change and growth.