Caregivers Need Education to Ensure Medication Adherence
Gagliano, Nancy J., DuPaul, Chris, Aging Today
With the aging of the baby boomers, our population mix is trending older. At the same time, chronic conditions such as obesity, heart disease and diabetes are increasing. As the incidence of such diseases continues to rise, so does their cost to society. However, the one party often overlooked in discussions about cost and service is the caregiver.
Caregivers are filling in where our healthcare system comes up short, and they need education and support as they struggle with managing the complex healthcare needs of their loved ones. One particularly challenging area is managing medication regimens.
Multiple Medications Hard to Track
A 2011 study on how the complexity of treatment regimens affects adherence to cardiovascular medications, published in the Archives of Internal Medicine (171:4) by CVS Caremark, Harvard Medical School and Brigham and Women's Hospital, found that over the course of 90 days the top 10 percent of statin users also take 23 or more medications; make 11 or more pharmacy visits to two or more pharmacies; synchronize only 10 percent of refills; and have four or more prescribers.
Managing so many medications can be a daunting task for patients and their caregivers, but the research is clear that the consequences for not doing so can be dire. A 12-week study from 2008, published in the Canadian Medical Association Journal (178:12), showed that more than one in nine of all emergency room visits were medication-related, ranging from patients who did not take their medication as prescribed to those who had an adverse drug reaction.
Researchers evaluating a cohort of older ambulatory persons estimated that as many as 27.6 percent of adverse drug events are preventable, and occur most commonly with cardiovascular drugs, diuretics, non-opioid analgesics, anti-diabetic agents and anticoagulants, according to a 2003 article in the Journal of the American MedicalAssociation (289:9).
Synchronize Refills and Simplify Regimens
Patients and their caregivers should find ways to simplify prescription regimens-clarifying when and how medications should be taken, and how often prescriptions should be refilled. For example, 90-day supplies can reduce the number of trips to the pharmacy and are available at retail cost under most insurance plans. Synchronizing refills can sometimes be tricky because of restrictions that insurers place on when patients are eligible to refill a prescription. However, pharmacists can work within a patient's plan design to help synchronize prescription refills over time.
Unfortunately, some of the greatest challenges for caregivers and patients involve how patients take medications at home. There is considerable variability in how prescriptions are written by physicians and transcribed by pharmacists, so patients often misunderstand label instructions. …