Physicians May Be Underestimating Patients' Nonadherence

While physicians recognize medication adherence is an extremely important factor in clinical outcomes for patients with chronic conditions, respondents in a new survey from HealthPrize Technologies seemed to overestimate the medication adherence and persistence of their own patients.

On a scale of 1 to 10, with 10 representing extremely important, nearly all (96%) primary care physicians who participated in the survey ranked the importance of medication adherence on clinical outcomes in diabetes, hypertension, and high cholesterol as an 8 or higher.

However, while physicians ranked medication adherence as very important, less than half said they include adherence counseling when prescribing a new treatment. Instead, they include counseling at follow-up visits.

“This is concerning, especially given the high rates of primary nonadherence, or failure to fill a prescription even once, and given that patients are at greatest risk of nonpersistence, or quitting therapy altogether, within the first few months,” Katrina Firlik, MD, co-founder and chief medical officer of HealthPrize, said in a statement.

The physicians who took part in the survey seemed to be more optimistic about their own patients’ adherence compared with published studies. While primary nonahderence rates can be between 15% and 30% across medications for chronic conditions, more than a third of respondents believed that the rate was less than 10% for their practices.

The results of the survey imply that “many physicians are simply unaware of their patient’s true adherence rates, leading to an underestimation of the extend of the nonadherence problem,” Dr Firlik wrote in the accompanying white paper.

A quarter of physicians said they did not want to receive medication adherence data and 25% were interested but did not believe they could influence adherence in their patients. The respondents said the reasons that most influence why patients don’t take or refill their medication was cost and the experience of a side effect.

Only a small number of physicians (9%) believe that education could strongly influence or potentially influence medication adherence, while far more said rewards (40%) and copay discounts (39%) were strong influences.

“Pharmaceutical companies should take particular note of the nearly identical weighing of rewards and co-pay discounts in the minds of physicians,” Dr Firlik said. “They sponsor co-pay discounts for the vast majority of branded medications, but very infrequently offer rewards programs. Based on the results of our survey, it could be argued that rewards programs should be implem