The American Medical Association notes, “Medication adherence is a growing concern for physicians and health care systems. There is increasing evidence of noncompliance among patients and correlated adverse outcomes that follow.” (January 29, 2020). Marie T. Brown, MD, a geriatric and internal medicine specialist at Rush University Medical Center, in Chicago has been studying this. She has been listening to patients and her fellow clinicians to get to the root cause of why patients don’t adhere. Reference Building patient trust to support medication adherence (American Medical Association) for more information.
Poor communications between clinicians and patients combined with poor or inconsistent education about medications are key factors contributing to non-adherence. When coupled with other patient barriers and concerns, adherence is driven lower. Among those barriers are that patients:
- Don’t think they need the medications anymore – especially true for “silent killers” such as hypertension and kidney disease;
- Fear side effects from taking the medication;
- Cannot afford the medications
- Distrust medicine and/or pharmaceutical companies
Non-adherence to other care plan tasks can be attributed to similar factors, for example, important tasks assigned to patients following surgery, such as tracking symptoms of infection or other clinical complications and maintaining physical activity and physical therapy.
Patient Reported Outcomes Measures (PROMs) can play a role in overcoming these barriers, particularly PROMs that are easily accessible to patients through their mobile devices. Mobile apps like Trusted Patient Coach™ (TPC) are clinically proven, intuitive, reliable ways to collect standardized, consistent PROMs data directly from patients about medication and care plan adherence and patients’ clinical status and progress.
Daily PROMs demonstrate higher adherence reinforced by both daily routines for patients and the regular connection with and monitoring by their clinical teams. As patients report taking their medication, indications of infection or other clinical issues, their clinical team can intervene early, before an issue festers into a more serious problem.
In using daily or routine mobile tools like Trusted Patient Coach, the physician and patient now have a stronger connection showing the patient that the physician really cares about adherence and therefore their overall outcomes and well-being.
Patient education about medications are extremely important, which can be reinforced with PROMs tools. For example, one of the clinician and patient groups using Trusted Patient Coach prescribed aspirin post-surgery as an anticoagulant; reported adherence was dropping. Clinicians followed up the non-adherence and learned that patients thought aspirin was for pain and had stopped taking it as pain subsided. Up front patient education and providing education through the TPC mobile app helped to correct this gap, leading to higher anticoagulant adherence.
The easy to use connection and timely responses between the patient and his/her clinical team help to re-enforce essential patient-clinician communications. Use of Trusted Patient Coach by patients in post-surgery recovery and supporting chronic diseases such as Substance Use Disorders, has demonstrated steady adherence and enabled the human touch and trust with clinical teams.