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Listen to Reason: Patient Reasons for Medication Noncompliance

Amanda Stevenson-Grund - Friday, March 13, 2015

“Patients don't take their medications for a multitude of reasons, many of them emanating from the murky depths of human psychology, and which the patients (not to mention medical researchers) may not fully understand.”
Chesanow, Why Are So Many Patients Noncompliant? Medscape Multispecialty. 2014

Finger touches text that spells compliance in large letters 

Medication use and health care costs have steadily increased during the past decade in the United States. Adherence to medication therapy is often a critical aspect of medical treatment, especially the treatment of chronic conditions. The World Health Organization notes that the average nonadherence rate is 50% among patients with chronic illnesses. Causes of medication noncompliance can start with the patient, the physician or the medication, itself.

Patient-based causes of noncompliance include forgetfulness; cost and inability to get a prescription filled, picked up or delivered. Forgetfulness causes about a quarter of noncompliance cases. This becomes more of a problem with older patients and patients with cognitive disabilities. This contrasts with patients who would remember to take medication but cannot obtain it in the first place because they lack the resources and support systems to pay for and collect their medications. High costs account for 17% of noncompliance cases, and inability to obtain filled prescriptions accounts for 10%.

Physician-based causes of noncompliance are those in which the issues start with the physician. These include poor doctor-patient relationship and lack of communication. For example, physicians who do not know their patients well do not know which issues are more likely to affect compliance. Additionally, doctors need to take the time to explain the importance of the medication and how to use it. Seventy percent of more than 1000 noncompliant patients said they would be more compliant if they knew more about their illness or condition and how the prescribed medication would help, according to Oyekan et al. in The Permanente Journal.

Medication-based noncompliance cases are caused by the medication, itself. Adverse events caused by medication can be more uncomfortable than the actual disease symptoms. Perceived side effects cause 20% of medication noncompliance cases. Complicated regimens can also lead to patient noncompliance. According to a study by Claxton et al. in Clinical Therapy, the higher the number of doses a patient must take in a day, the less likely the patient is to be compliant.

The first step to addressing nonadherence is to recognize that collaboration must occur among pharmaceutical companies, health care providers and patients. At Orbis, our science has the potential to improve the lives of patients by easing the burden of taking medication and increasing compliance. Combining that with our passion and commitments to making medication better and easier to take, we could have a great impact on patients’ lives.

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