Drug Adherence Focus of Meta Study

A standard method of measuring patient adherence to medications would go a long way toward addressing this vexing health care problem, according to a study in the Journal of the American Pharmacists Association.

The study “Targeting Cardiovascular Medication Adherence Interventions” states that “Adherence measures differed between studies both as an outcome and a means of defining a target group. This heterogeneity prevented us from pursuing a meta-analysis and prompted us to interpret all findings with caution.”

The authors do cautiously suggest that interventions focused on nonadherent patients are more effective than programs that send out warnings and encouragement to all medication users. “Broad interventions were less likely (18 percent) to show medium or large effects compared with focused (25 percent) or dynamic (32 percent) interventions,” the study states.

Focused interventions target nonadherent patients, and dynamic interventions are administered “to all medication takers, with real-time adherence information targeting nonadherers as intervention proceeded.”

Nonadherence to medication use accounts for about $290 billion in excess costs to the U.S. health care system annually, the study states.

The effectiveness of broad interventions was “likely diluted because of the small effect of the intervention on patients already inclined toward adherence. Moreover, without the benefit of identifying patients and their specific barriers to nonadherence, these interventions may have been too general to motivate individual patients to meaningfully change their behavior. In a resource-constrained health care system, broad interventions without a feedback loop may not provide the best return on investment.”