Medication adherence – it’s not a diagnosis but it is an issue affecting many of our senior clients. It’s one of the main reasons so many are heading back to the hospital after being discharged home. According to a New York Times article, medication adherence is an ‘out of control epidemic in the U.S. that costs more and affects more people in the U.S. than any disease Americans are concerned about – and it is 100 percent preventable.’
Causing an estimated 125,000 deaths a year, not adhering to medications costs the healthcare system between $100 billion and $289 billion a year. The good news – there’s something we can do about it.
Financial constraints continue to be the number one driver behind seniors not adhering to their medications. It’s understandable when many are on fixed incomes and the cost of prescription drugs are doubling to more than $11,000 for a year’s supply. But another study argues that ‘even if drugs were free, nonadherence would persist.’ Why? The study points out that even among patients who have health plans with no cost-sharing for medications, rates of nonadherence were nearly 40%.
The important of medication adherence isn’t new to many of us. We see it every day with the clients we serve but perhaps understanding the underlying issues our senior clients face when it comes to medication adherence might just help begin to lower the statistics and improve outcomes long-term. Consider these top four non-adherence drivers (after finances) and what you can do about it:
- Lack of coordination – Your client and their family caregiver understood the discharge instructions clearly. Once they transition home, that’s where the gaps occur, in those first few days when they are left on their own to review the paperwork, coordinate the next steps, manage medications, etc. – it can be an overwhelming task for many.When Tim discharged home after having a stroke, it was in the first few hours that his Life Care Manager realized there was something wrong with the medications he want sent home with, some were missing. Tim’s wife would never have known to catch something like this and it would have resulted in an emergency trip back to the hospital. Coordinating medication adherence details with the senior after discharge is critical to ensuring follow-through.
- Transportation Issues – Often it’s not that seniors won’t take their medications properly but that they can’t get to the pharmacy on their own. Either they aren’t driving or they were told not to with the prescribed medication they are on due to side effects. With no one to support them, how will they accomplish this? Asking them prior to discharge how they will get their medications will help you work with senior care options that offer transportation if it’s an issue.
- Side Effects – Who will monitor seniors once home for any potential side effects or risks? Consider sending them home with a trusted advisor who will ask important health questions that could signal a red flag that something is wrong, take vital signs, manage their medications, give them the opportunity to ask questions, and review medication lists once more.
- Improperly Taking Medications – There’s a greater need for healthcare professionals to have the tools they need at discharge to properly assess a client’s ability to adhere to medications. For example, will they be able to cook meals and eat a well-balanced diet that enhances medication absorption or are they physically able to open the pill bottles and access their medicines? Are they cognitively sound to remember when and how many pills to take when the time comes? Asking these types of questions at discharge and even asking the client to demonstrate their capability might prevent an issue down the road.
Helping seniors have positive health outcomes long-term takes a whole person approach to understand all factors that could impact their ability to adhere to medications and overall health goals once home. This is just a starting point of what we can do every day to ensure seniors don’t return to the hospital or worse, become another statistic.
We want to know, how are you helping seniors adhere to their medications? Share your tips…