Optimizing adherence has positive impacts on many aspects of healthcare, including outcomes, quality, and costs. When taken all together, these impacts provide clear incentives for HCPs to work harder to achieve better adherence.
Optimizing Adherence and Outcomes of Care
Many of you I’m sure are familiar with the ‘Physician Charter’, published in Annals of Internal Medicine in 2002 (see here). This multinational consensus drew on both European and U.S. expertise to create a set of 10 commitments. These commitments restate professional responsibilities in the context of challenges for the new millennium.
As a scene-setter for this post, I’ll focus on the commitment #5 from this ‘Charter’, which addresses quality of care. The essence of this commitment for physicians (and other HCPs) is as follows:
“Work collaboratively with other professionals to reduce medical error, increase patient safety, minimize overuse of health care resources, and optimize the outcomes of care.”
(The emphasis above on outcomes of care is mine.)
There are many potential paths for achieving better outcomes. For the moment though, I’d like to address just one of them: to propose why HCPs should work harder at optimizing adherence.
7 Benefits of Extra Focus on Optimizing Adherence
1. Improved Treatment Success
When patients take medications as prescribed, the chances of treatment success (eg, lowering BP, reducing HbA1c levels) are markedly improved. This is not only good for the patient but also good for the HCP …
2. Increased HCP Satisfaction
For HCPs, feelings of personal satisfaction can be elusive. Investing effort in optimizing adherence not only pays back in terms of improved treatment success. It can also pay back in terms of the increased sense of satisfaction HCPs may feel from a job well and fully done.
3. Reduced Healthcare Costs
The pressures to control rising healthcare costs are huge. In a recent report (see here), the increased healthcare costs associated with non-adherence in the U.S. were estimated at $290 billion. Increased focus on optimizing adherence can help curb these extra costs, while also improving treatment success and increasing satisfaction. A win, win, win!
4. Taking Responsibility for Adherence
It has been suggested (see here) that physicians see patients as being primarily responsible for adherence. In everyday practice though, patients need HCP help to get them on the right track. This is especially so when patients have motivational issues that undermine their intent to adhere. Optimizing adherence is shared responsibility between the patient and HCP. It’s vital however that the HCP steps up to take on his or her adherence responsibility to get things moving.
5. Achieving HCP Rewards for Quality
As time moves forward, more emphasis will be placed on the ‘quality of care’ provided, as opposed to ‘quantity of care’. The exact measures of ‘quality’ will likely evolve over time, but will surely include components relating to outcomes and patient satisfaction. Outcomes are positively influenced by adherence. So there’s a direct relationship between adherence and quality; greater investment in the former can influence greater rewards through the latter.
6. Adherence Tools Are Readily Available
To help HCPs in optimizing adherence, many different tools are available. These range from reminder apps for mobile phones, to web sites that engage and educate patients, to HCP training programs that help improve communication with patient and can also help in building patient motivation to adhere. These tools can work in concert with practice efforts to increase patient commitment to adhere.
7. Better Treatment Outcomes
“Drugs don’t work in patients who don’t take them.”
C. Everett Koop
Physicians put a lot of effort and care into making the right diagnoses and prescribing the right treatments. But all that care is for nothing if patients don’t adhere. Investing a little more time to motivate and support the patient to adhere to treatment carries as much importance as the initial diagnosis and treatment choice. Only when medications are taken correctly and consistently over time will better patient outcomes be achieved.
The roles of physicians and other HCPs in fulfilling this vision are paramount.