Pacific College holistic nursing faculty members Mitzie Meyers, PhD, RN, CNE, AHN-BC and Caroline Ortiz, PhD(c), MSN, MPH, RN, NC-BC were recently interviewed for an article series by Andy Oram on problems people have taking their medication. Up to half of all patients who are prescribed medications for management of chronic conditions don’t take them properly–or sometimes, at all; one in five prescriptions waiting at the pharmacy don’t even get picked up. The cost of this problem is vast: hundreds of thousands of preventable deaths and hundreds of billions of dollars each year–possibly as much as 20% of all US healthcare spending, according to one estimate. Oram’s article series discusses multiple ways to address this problem.

Using Technology to Address Medication Access

In the United States, patient adherence to medication regimens drops drastically when the patient’s cost for that medication exceeds $50. Patients will fail to pick it up, fail to refill it, or take less medication, or take it less often than prescribed, all in the name of saving money–and justifiably so. The US is notorious for its bloated healthcare costs. Recent technological advances may help mitigate this, by providing up-to-date and transparent pricing, instead of the labyrinthine, obfuscated pricing modern Americans have been forced to grow accustomed to. Read More

Helping People Take Their Meds

IT solutions can also involve reminders, remote patient monitoring, and offers of online connections with clinicians or caregivers; text messages, app notifications, and even gamification can all help. Pacific’s Dr. Ortiz discussed obstacles to adherence like anxious patients that forget or don’t understand their doctor’s instructions, or can’t understand due to a language barrier. Both the healthcare provider and patient need extra support to ensure medication adherence–and technology can help. Read More

What Tends to Go Wrong With Medication Adherence?

A breakdown in medication adherence also often occurs immediately upon discharge from a hospital: Pacific’s Dr. Meyers points out that many patients enter the hospital in a crisis. Because payers want them discharged as soon as possible, they’re often exhausted, in pain, angry about needing new medication, or frustrated by their less-functional body while the hospital staff is trying to teach them about an array of unfamiliar pharmacologies. Afterwards, a nurse might follow up with a call at the most–this isn’t enough. Read More

Rethinking Medication and Information Technology

Oram’s final article in the series turns the question on its head: can patients get better without medications? Family, friends, and even community institutions can encourage them to adopt better habits, but Dr. Meyers emphasizes that the patient-practitioner relationship must be collaborative. Do the medications truly need to be prescribed? Some drugs, such as those for depression and anxiety, are notoriously overprescribed. Although some patients blindly request antibiotics, they won’t do anything for a viral infection. Dr. Ortiz reminds us that a patient’s reasons for altering or diverting from the medical plan can be many and varied. Read More

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