Insurers take on patients’ lapses By Katie Merx
Detroit Free Press, August 13, 2006
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Following a brief discussion of the prevalence and the costs of medication noncompliance, this article focuses on the means by which several health plans, including HealthPlus, Blue Care Network, Health Alliance Plan and Care Choices, have begun monitoring how patients with chronic disorders fill their prescriptions and working to alleviate problems if those prescriptions are not filled appropriately.

HealthPlus, a managed care plan, followed patients who were prescribed medications for diabetes, elevated cholesterol and high blood-pressure and who also had a history of noncompliance. When noncompliance was discovered, the doctors of these patients were notified and the patients themselves were sent personalized letters explaining why they should take their medicines.

According to Helen Leonard, the clinical pharmacy program administrator at HealthPlus in Flint,
After three years of tracking results, 77% of noncompliant patients with high blood pressure, 56% of noncompliant diabetic patients and 49% of noncompliant cholesterol patients were taking their medications.

Ms Leonard is further quoted as saying, “In talking to members, it seems there is just a lack of understanding about why they should take their medicines.”

The article also reports that “pharmacists said” that the common reasons patients stop taking prescribed medications are

• The drugs cost too much or cause side effects
• They feel better
• They notice no change (as is often the case with antidepressants)

Commentary

While the notion of monitoring and taking action about noncompliance seems straightforward and a mutual benefit for the healthcare plan and the patient, the declared improvement in adherence rates is unclear, at least to me.

The statement, “After three years of tracking results, 77% of noncompliant patients with high blood pressure, 56% of noncompliant diabetic patients and 49% of noncompliant cholesterol patients were taking their medications,” doesn’t sufficiently the criteria for either “noncompliant” or “taking their medications.”¹ Given the results of previous research and experience, it is difficult to understand how the notification of patients’ physicians and sending explanatory letters to noncompliant patients would achieve that magnitude of gains if “taking their medications” means “fully compliant.”

Likewise, the contention, attributed to “pharmacists” that “Patients commonly stop taking medicines because the drugs cost too much or cause side effects, they feel better or, as is often the case with antidepressants, they notice no change,” appears at best simplistic.

I am attempting to garner details about these findings and will report whatever I discover here.

Footnote

1. The article does appear in the lay press and does not pretend to the rigor of an article published in a professional journal; still, this claim seems ambiguously worded. [back]

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