Boosting Quality, Patient Adherence While Cutting Costs with Medication Management Devices

By Rosemary Kennedy, PhD, RN

Medication non-adherence, particularly among senior patients, is a costly problem facing the American healthcare system. This issue results in an estimated $100 billion–$290 billion in annual costs, according to studies reviewed in the Annals of Internal Medicine (AIM). Other research cited by AIM indicates that 20%–30% of prescribed medications go unfilled by patients and approximately 50% of medications for chronic diseases aren’t used by patients as prescribed.

The latter statistic is striking, considering that older patients often suffer debilitating and costly effects of multiple chronic diseases such as heart disease, diabetes, and COPD. Additional studies reviewed by AIM estimate that medication non-adherence is responsible for nearly 125,000 deaths annually in the U.S.

Previously hospitalized patients with low and intermediate adherence (combined) had a 30-day readmission rate of 20.0%, according to a 2017 study—more than twice the readmission rate (9.3%) for patients with high medication adherence.

There are several reasons why elderly Americans fail to adhere to their medication plans, ranging from forgetfulness or confusion to fear of side effects, the high cost of their prescriptions, and mistrust of their clinicians.

Still, plenty of strategies and tools for patients, caregivers, providers, and payers can help ensure adherence to medication prescription plans. When effective, these approaches can lower healthcare costs by reducing unnecessary doctor appointments and visits to the emergency department. Additionally, these strategies and tools allow clinicians to properly utilize their resources, focus on fewer patients, and deliver improved quality of care in line with the triple aim.

Best practices and processes

The most effective medication strategies include reducing out-of-pocket expenses to make it easier for patients to purchase their prescribed medications; case management; and patient education with behavioral support and technology. According to the aforementioned AIM analysis, those three strategies improved medication adherence among patients with multiple chronic diseases.

Several apps allow users to place orders with their pharmacy and refill prescriptions at the appropriate time. Similarly, medication management apps combined with tamper-proof automated pill dispensers help senior patients take the correct dosages of prescribed medications. Medication management technology increases adherence by an estimated 40%, “potentially saving 50,000 lives and $120 billion each year,” according to Today’s Geriatric Medicine.

Another available tool is telemedicine, which has a proven track record of keeping elderly patients on their prescribed medication schedules. Remote patient monitoring also allows providers to collect patient vitals daily, and this information can be aggregated with data from the patient’s electronic health record to provide insights into medication adherence. For example, if a patient’s daily vitals show glucose levels or blood pressure trending higher, providers can intervene and keep the patient on track.

Beyond preventing unnecessary emergency department visits and hospitalizations, clinicians can also assess patients and intervene remotely, using their time more efficiently and reserving clinician resources for more severe utilization of care.

As reimbursement becomes increasingly tied to quality measures under value-based care agreements, taking medications as prescribed has a significant impact from a measurement perspective. Perhaps most meaningfully, effective medication management produces a higher quality of care because care resources can be better allocated. Patients stay healthier, healthcare costs are reduced, and the overall healthcare system becomes more efficient.

Healthcare has typically been slow to adopt new technologies, though COVID-19 has caused providers to rethink their business models in the face of unprecedented change. Luckily, many provider organizations have acted nimbly by learning to use technology to supplement their clinical staff. Through utilizing medication management tools and strategies, providers can reduce healthcare costs, improve adherence, and bolster care quality.

Rosemary Kennedy, PhD, RN, is chief health informatics officer at Connect America.