The Recommendation

Enhancing Prescription Medicine Adherence: A National Action Plan, the report referenced in my snarky August 1, 2007 post,¹ is available² and worth reading by anyone involved with healthcare.

The Report

While I won’t go into detail about the Report’s content, I will note that the prose is lucid and well organized,³ the ideas are drawn from a wide and diverse group of sources, supportive evidence is provided, and the conclusions are neither grandiosely nor apologetically offered.

The headings of the Report’s 10 PRIORITIES FOR ACTION are excerpted below:

1. Elevate patient adherence as a critical health care issue.

2. Agree on a common adherence terminology that will unite all stakeholders.

3. Create a public/private partnership to mount a unified national education campaign to make patient adherence a national health priority.

4. Establish a multidisciplinary approach to compliance education and management.

5. Immediately implement professional training and increase the funding for professional education on patient medication adherence.

6. Address the barriers to patient adherence for patients with low health literacy.

7. Create the means to share information about best practices in adherence education and management.

8. Develop a curriculum on medication adherence for use in medical schools and allied health care institutions.

9. Seek regulatory changes to remove roadblocks for adherence assistance programs.

10. Increase the federal budget and stimulate rigorous research on medication adherence.

The Potential

The strength of the proposal lies in its promotion of patient compliance as an essential factor in healthcare and, even more significantly, its campaign to unite stakeholders in an unified effort.

Of course, much of my current enthusiasm is generated by the fact that I’ve been singing the alignment of stakeholders hymn for years.

And, there are potential problems as well. While the Report covers many strategies, its sponsor, the National Council on Patient Information and Education, as indicated by the organization’s name itself and its ubiquitous motto, “Educate Before You Medicate,” has historically held patient education to be the touchstone of effective medication prescription and administration. As its web site proudly points out, NCPIE’s historical mission has been assuring patient safety through “enhanced communication.” Given that the plan NCPIE proposes, unsurprisingly enough, places NCPIE at the center of this new alliance of stakeholders, there is the risk that its organizational culture and its bias toward patient education could skew the campaign’s strategies. A similar but lesser concern is that the program will focus predominantly or exclusively on medication compliance rather than adherence to treatment in general because that has been NCPIE’s heritage.⁴

Also, persuading the government to fork over more money, even when the need is clear and the uses of the funds worthwhile, will not be a simple matter.

Perhaps even more difficult will be garnering the buy-in of clinicians, governmental agencies, for-profit and not-for-profit healthcare organizations, employers and other funders of healthcare, pharmaceutical companies, and patients to the same plan.

Nonetheless, Enhancing Prescription Medicine Adherence: A National Action Plan seems the most cogent and potentially workable large scale medication compliance enhancement plan published to date.

Accessing Enhancing Prescription Medicine Adherence: A National Action Plan
The report is available in PDF format at ~NCPIE Report and Action Plan PDF~

A Note Re Yesterday’s AlignMap Post
My post yesterday, News Flash! U.S. Government Discovers Treatment Adherence Not 100% - War On Noncompliance Declared, which referenced this Report (which I hadn’t been able to access at the time), was sardonic, mocking, and critical.

In light of what I’ve written in today’s post, the comments in yesterday’s blog entry - are still valid and still heartfelt.

Specifically, I maintain now as I did yesterday when I wrote the preceding post that (1) healthcare noncompliance is not a new discovery but has been a concern to many of us for a long time, (2) there is nothing I find in my initial reading of this report about the nature of noncompliance and its causes that is new, and (3) to the extent that patient education is the total focus of any new program, that program’s potential success is severely and needlessly limited.

Footnotes

1. See News Flash! U.S. Government Discovers Treatment Adherence Not 100% - War On Noncompliance Declared [back]
2. There is some potential for confusing the the report with its press release. The press release (aka Media Advisory), which is more useful than most examples of its genre, is entitled “America’s Other Drug Problem Poor Medication Adherence” and can be found at Online Press Release re NCPIE Report. The press release is also available as a four page PDF document at PDF of Press Release re NCPIE Report. While it’s not clear from the press release, the 34 page report itself is available on the web site of the National Council on Patient Information and Education, the group that organized the study. On that site, the link to the report (in PDF format) is Enhancing Prescription Medicine Adherence: A National Action Plan, which is the same name found on the title page of the report. [back]
3. The clear writing is unusual enough in papers of this kind to warrant a recommendation for reading [back]
4. I should note that while I have no direct connection with NCPIE, I’ve used their materials extensively over the years and have found them a trustworthy organization providing useful services and materials. [back]

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