Comparative Effectiveness

Tactics to improve medication adherence in short-term shown effective

A new evidence report from the Agency for Healthcare Research and Quality (AHRQ) found consistent evidence that patients were more likely to follow medication instructions if given incentives such as reductions in out-of-pocket prescription drug costs or improvements in prescription drug coverage. Case management and educational interventions were also shown to improve medication adherence. The tactics were shown to be effective for a wide range of chronic illnesses, including asthma, depression, diabetes, and cardiac conditions.
Studies estimate that half of all medications for chronic conditions are not taken as prescribed, and medication non-adherence costs the U.S. health care system between $100 billion and $289 billion annually in direct medical costs. The strongest evidence came from studies using medication self-management for asthma patients, collaborative care or case management for patients taking drugs for depression, and pharmacist-led approaches to improve systolic blood pressure in hypertensive patients.
Meera Viswanathan, Ph.D., led the team of researchers at the Research Triangle Institute International-University of North Carolina Evidence-based Practice Center. He noted that there was limited evidence as to whether the approaches studied have broad applicability for chronic conditions and patient populations. The team also found limited evidence of these tactics for long-term medication adherence or health outcomes.
The review is part of a larger initiative, Closing the Quality Gap: Revisiting the State of the Science, and builds on an earlier AHRQ series of evidence reports, Closing the Quality Gap: A Critical Analysis of Quality Improvement Strategies. The initiative was developed by AHRQ's Effective Health Care Program, which funds effectiveness and comparative effectiveness research and makes findings available for clinicians, consumers, and policymakers.
To read Medication Adherence Interventions: Comparative Effectiveness, go to the Effective Health Care Program Web site at http://www.effectivehealthcare.ahrq.gov.