The Importance of Medication Adherence in Improving Chronic-Disease Related Outcomes

Abstract

in chronic conditions is a recognized public health problem. Rates of nonadherence with any medication treatment may vary from 15% to 93%, with an average estimated rate of 50%. 3 The association among increased medication adherence, improved health outcomes, and lower healthcare costs is well known. 4 Many factors may influence patients’ adherence to the medication intervention: patients’ demographics, cost of medications, number of medications taken by the patient, nature of the medical intervention, and nature of the medical condition. 5,6 Healthcare costs have shown to vastly differ among patients with high and low adherence, with a clear relationship seen between increased medication adherence and lower healthcare costs. 7 Patients’ failure to adhere to the medication regimen may cost as much as $300 billion to the healthcare systems in the United States. 8 In this issue of Medical Care, Sokol and colleagues present the findings of a retrospective cohort study of 137,277 patients enrolled in medical and prescription benefit plans, in which they examine the relationship between medication adherence and healthcare utilization and costs for 4 chronic conditions: diabetes, hypertension, hypercholesterolemia, and congestive heart failure. This research represents an important milestone in our understanding of the role of medication adherence in chronic diseases. 9 Not only does this research show that higher medication adherence is associated with lower avoidable healthcare utilization and morbidity across many chronic conditions, it establishes the role of increased medication utilization and adherence in the effective management of the chronic disease condition. Medication nonadherence with medication regimens is a well-recognized, but understudied, public health problem. 1– 8 This effort by Sokol and colleagues represents one of the first times the ramifications of medication nonadherence in affecting patient morbidity are studied and compared across 4 prevalent chronic medical conditions using large patient samples. The next steps after establishing the clear associative relationship between medication nonadherence and poor patient outcomes should be: 1) to confirm these strong associative relationships as being causal by using