Improving patients’ beliefs about their medication therapies may significantly improve medication adherence, according to a set of studies sponsored by drug maker Merck and presented last month at the International Society for Pharmacoeconomics and Outcomes Research’s 16th annual international meeting in Baltimore.
“We believe it is Merck’s outcomes and adherence research programs that truly differentiate us from other healthcare companies,” Merck spokesman Jim Brinckman told Drug Store News. “To that end, the company has made adherence a top strategic priority.” Merck has created a number of tools designed to help pharmacists and patients address adherence, such as the “Adherence Estimator,” a self-scoring patient survey.
In one study, patients who had various chronic conditions in 2008 were mailed a survey that assessed their perceived need for medications, concerns about side effects, perceived affordability of medications, perceived severity of their disease states, the trust they placed in their physicians, concerns about medication safety and the perceived value of their drugs. The study then measured whether they continued or discontinued therapy based on gaps in pharmacy claims data, grouping respondents according to discontinuation after the first, second, third and fourth or subsequent fills; those who were persistent over a 14-month period but had gaps in therapy; and those who were persistent without any gaps. The researchers said the results showed that patients’ beliefs may not only help predict whether they will discontinue therapy, but also when. “Improving medication beliefs may help to move patients gradually along the continuum from early nonpersistence to perfect adherence,” the researchers wrote.
Another study explored the relationship between intentional and unintentional nonadherence, which refers to conscious decisions not to take medication as directed versus the inability to do so. Researchers surveyed 24,071 adults with asthma, hypertension, diabetes, hyperlipidemia, osteoporosis or depression from the Harris Interactive Chronic Illness Panel. Patients answered questions about adherence and beliefs about their medications, generating scales assessing perceived medication need, concerns and affordability. The researchers found a significant relationship between unintentional and intentional nonadherence, concluding that the former may help predict the latter. A significant relationship also was found between medication beliefs and intentional and unintentional adherence.
The studies follow the January publication of a Merck-sponsored study in the journal Health Affairs that found employers that lowered co-payments on prescription drugs while promoting disease management could lower their own healthcare costs. That study, which focused on patients with diabetes, found that employers combining disease-management programs with “value-based insurance design” can earn a return of $1.33 for every dollar they spend upfront on medication.