Patient Compliance: Is There a Solution? - 3

Here are some more percentages on Noncompliance from the MedAdNews Trend Report:

So here's the MDs take on noncompliance:
Sex Breakdown
Men: 65%
Women: 5%
Equal: 30%
Age Breakdown
18-34: 23%
35-49: 27%
50-64: 23%
65+: 17%

Real numbers based on Guideline Survey:
Female: 62%
18-34 65%
35-54 63%

As you can see, the MDs are really, really wrong about who they believe is compliant. It could go back to the "white coat" adherence I wrote about in June. I would imagine the majority of patients do not get their blood tested regularly, so the MDs have to rely on what their patients tell them. (I have to admit that I have not gone to have my follow-up blood work done - I'm only two months late. Also going to the dentist today but I will not lie - I do not floss as much as I should).

Here are some numbers on specific ailments:
Insomnia: 84% - wouldn't they realize they are awake and take their medication?

Incontinence: 78% - I would think that after one or two public incidents that they would take their meds.

Depression: 77% - this is understandable. One of my psychologist friends told me that the reason sucide rates are higher among teens on antidepressants is because the antidepressants start to work and get the teens into a state of motivation to commit suicide, whereas without them, they are too depressed to do anything. Kind of a horrible fact.

Pain: 77% - again, I would think that if you are in pain, you would take your meds.

Asthma: 76% - if it is hard to breathe, take your meds.

Anxiety: 75% - I can understand this one due to side effects and when their medication is working, they feel they no longer need it, thus they stop taking it and become anxious.

There are more facts and factors covered in the report, but only two more which are reflective of the high costs of medications.

When the MDs were asked what they thought the number 1 reason for noncompliance - 71% responded: "My patients cannot pay for all their medications".

67% of patients and 95% of MDs stated their #1 interest in a program to enhance compliance would be "a discount program for those who renew their scripts on time" .

At least we all can agree on one thing - medications are too expensive and if they were cheaper, everyone would take more.

Speaking of paying for medications, my new company is on an HSA program (which is supposed to save us money) but with my medications (2), my wife's meds (2) and our son's single prescription, the monthly cost was aobut $435 - not the $25 co-pay with my old program ($125). Granted with the HSA less is taken out of my pay and after the deductible ($4,000) is hit, everything is covered. However, getting to that number would take eight months of medication plus our twice a year check-ups - given that we are healthy. But HSAs are another post.

Patient Compliance: Is There a Solution? - 2

MedAdNews and Guildeline surveyed consumers and physicians to determine their attitudes about patient compliance. I attended their breakfast launch to hear the results and the panel discussion on Wednesday 06.27.07. Most of what they discovered I knew, however I was surprised by some of the stats which I will share here.

Morris Whitcup and Al Koster, both from Guideline, are credited as the authors of this study which was published as The Trend Report in June's MedAdNews. I am going to focus on the facts that I find interesting and were new to me, there is plenty more data in the report which I am not going to address.

Of those polled, 59% (6 in 10) said they were noncompliant during the past year. Pretty Standard.

They broke down the noncompliant by Behaviorally Noncompliant (BN) and Attitudinally Noncompliant (AN). I had never heard of that breakdown and think it is an interesting measure. 27% (1 in 4) of respondents were attitudinally noncompliant - meaning that their answers based on the questions asked, reflected a noncompliant attitude. There was also crossover with behaviorally noncompliant in this group.

After accounting the overlap with the two groups, Guideline found that 64% (2 in 3) polled were noncompliant.
Attitudinally Only: 5%
Behaviorally Only: 37%
Both: 22%
Neither: 36%

The results using this BN and AN were fascinating, as the AN were the most interested in learning more about medications, would be more compliant if they understood the importance of taking medications (60%), were the most knowledgeable in the family about medications (59%), and thought it was OK to skip a dosage or two (39%).

The AH did admit to not being as careful as they should about taking their medications properly (67%) and thankfully the majority said they were more careful with their children's medication that their own (61%). So pretty big numbers, some disturbing, some disappointing - 50% wished their doctor spent more time with them explaining their medication.

The physician's understanding or ideas about patient compliance were a little off the real numbers. Before that though, how long do you think the average doctor spends explaining medications to their patients? 2.9 minutes per the consumers, 3.2 mins per the physicians. That horrifies me. I do not go to the doctor that often, but at my first physical in 6 years Dr. Lim put me on Tricor for my trigliceride levels (diet, lack of exercise and inherited traits were the cause).

I did not time her, but it felt a lot longer than 3 minutes - the reason, what it does, the dosage, the side effects, how long I have to take it - could it all be summed up in three minutes? I also had two telephone conversations with her about it - lab tests, was it working, etc... Maybe I'm wrong about the time, but it is a pretty simple statin. I can't imagine if I had to take a complicated schedule with multiple medications and only have 3 minutes to get everything straight? No wonder the noncompliance rates are so high.

More to come.