Patient Education Key to Adherence

Patient education is one of the keys to optimizing patient adherence. In short: the more patients know about their disease and medication treatment plan, they more likely they are to adhere to their treatment.

Patient concerns about side effects are a significant barrier in patient adherence. Here at BioPlus Specialty Pharmacy, we know that the onset of treatment is the ideal time to set the stage for understanding the side effects of any new therapy. A survey by Harris Interactive found that 45 percent of patients reported not taking their medication due to concerns about side effects. [i]   Medications with bothersome side effects are more likely to be filled less frequently and are discontinued more often.[ii]   Another study showed that women with concerns about the adverse effects of their medicine were strongly associated with poor adherence.

Some people have wondered if providing patients with information about possible adverse effects could backfire and decrease adherence. However, the research clearly shows that this concern is unfounded.[iii]

The American Society of Consultant Pharmacists recommends that patients receive information (among other things) about the common adverse effects of a medication that may occur and what to do about them, as well as information about serious adverse effects to look out for and what to do if they occur.

According to Adult Meducations (a collaboration of The American Society on Aging and the American Society of Consultant Pharmacists Foundation), the ideal time to initiate adherence interventions is when therapy first begins. Interventions that are initiated early in the course of therapy can support patients through a period when they are most likely to have questions or to experience side effects from therapy.

An author of a 2011 study in the Journal of Family Practice points out that patient education should include the likely adverse effects of treatment and what can be done to minimize them. This study cites three prior trials examining this issue in relation to medication adherence.[iv]

A case in point is one recent study focusing on a patient education program for rheumatoid arthritis. [v] This education program resulted in a significantly higher adherence to the injectable rheumatoid arthritis medications. In this study, the education was conducted both over the phone and via mailed written material, including education to patients about adverse drug reactions. The author of this study notes that there are numerous additional studies with similar findings: that is, that patient education programs improve outcomes. Similarly, patient education significantly increased adherence to a rheumatoid arthritis drug in another study. The effect of the education persisted for six months.[vi]

As another example: a study in England involving patients newly prescribed medications for chronic conditions (stroke, CVD, asthma, diabetes, RA), found that patient education over the phone improved adherence rates by 7 percent and lowered medication-related problems by 11 percent. [vii]

Of course, here at BioPlus, we have been leading the charge in terms of patient education. We work on patient education from our first contact with each patient and all the way through the treatment process. We feel that our adherence rates – which are significantly higher than retail and mail order published rates – reflect, in part, the effectiveness of our patient education.

Stephen C Vogt, PharmD
President and CEO
BioPlus SP

[i] Harris Interactive Survey, 2005
[ii] J Manag Care Pharm. 2008;14(6)(suppl S-d):S2-S10
[iii] JAMA 2002;288:2868-79
[iv] Brunton SA. Improving medication adherence in chronic disease management. J Fam Prac 2011;60(4):S1-S8.
[v Stockl KM, et al. Outcomes of a rheumatoid arthritis disease therapy management program focusing on medication adherence. J Managed Care Pharm 2010;16(8):593-604.
[vi] J Hill, H Bird, S Johnson. Effect of patient education on adherence to drug treatment for rheumatoid arthritis: a randomised controlled trial. Ann Rheum Dis 2001;60:869-875.
[vii] Clifford S, Barber N, Elliott R, et al. Patient-centered advice is effective in improving adherence to medicines. Pharm World Sci 2006;28(3):165-70.

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