David Baxter PhD
Late Founder
Medications that are not taken cannot work
by Dr. Marla Shapiro, CTV Healthblog
January 17, 2012
As a physician, one of the concerns I have is the whole concept of so-called patient compliance with medication. We have learned that patient compliance is about initiation and then adherence and persistence to prescribed medication.
If medications are not taken properly, they don't work. In many cases, taking half the medication does not mean it works half as well; often, it simply won't work at all. We often talk about barriers to adherence including how complicated a dosing schedule might be and the route of administration. But often what is overlooked is affordability. Pure and simply, the cost.
This week a study in the Canadian Medical Association Journal looked at the impact of cost on adherence to prescription drugs. Overall, 1 in 10 Canadians report not adhering because of cost. However, those with low household income and no insurance coverage reported as much as 35.6% cost-related non-adherence. Overall, without insurance, 26.5% reported not being able to afford their prescription drugs.
Those most at risk -- those with fair or poor health status -- did not take their medications 2.6 times more likely than those in good or excellent health. Those with chronic conditions as well were 1.6 times more likely not to take there medicines due to cost. British Columbia as a province fared the worst as those living there were more than twice as likely to report not being able to afford their prescription drugs.
Half of total spending for drugs, the authors point out, is for medications that are intended for long-term conditions, such as heart disease. If we do not manage these conditions it leads to poorer health outcomes. The greatest risk for a heart attack is having already had one just as the greatest risk for an osteoporotic fracture is having had one.
Out-of-pocket expenses for Canadians were $4.6 billion in 2010. Two-thirds of Canadians incur expenses for medications, with those under 65 being the most impacted. If we manage our health well, costs will go down through fewer physician visits and acute hospitalizations.
How can we best achieve these goals?
WATCH: My medication chat on Canada AM
by Dr. Marla Shapiro, CTV Healthblog
January 17, 2012
As a physician, one of the concerns I have is the whole concept of so-called patient compliance with medication. We have learned that patient compliance is about initiation and then adherence and persistence to prescribed medication.
If medications are not taken properly, they don't work. In many cases, taking half the medication does not mean it works half as well; often, it simply won't work at all. We often talk about barriers to adherence including how complicated a dosing schedule might be and the route of administration. But often what is overlooked is affordability. Pure and simply, the cost.
This week a study in the Canadian Medical Association Journal looked at the impact of cost on adherence to prescription drugs. Overall, 1 in 10 Canadians report not adhering because of cost. However, those with low household income and no insurance coverage reported as much as 35.6% cost-related non-adherence. Overall, without insurance, 26.5% reported not being able to afford their prescription drugs.
Those most at risk -- those with fair or poor health status -- did not take their medications 2.6 times more likely than those in good or excellent health. Those with chronic conditions as well were 1.6 times more likely not to take there medicines due to cost. British Columbia as a province fared the worst as those living there were more than twice as likely to report not being able to afford their prescription drugs.
Half of total spending for drugs, the authors point out, is for medications that are intended for long-term conditions, such as heart disease. If we do not manage these conditions it leads to poorer health outcomes. The greatest risk for a heart attack is having already had one just as the greatest risk for an osteoporotic fracture is having had one.
Out-of-pocket expenses for Canadians were $4.6 billion in 2010. Two-thirds of Canadians incur expenses for medications, with those under 65 being the most impacted. If we manage our health well, costs will go down through fewer physician visits and acute hospitalizations.
How can we best achieve these goals?
WATCH: My medication chat on Canada AM
