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Dr. William Shrank, chief medical officer at the University of Pittsburgh Health Plan, said
that when Aetna offered free medications to patients who survived a heart attack, adherence improved by 6 percent and there were 11 percent fewer heart attacks and strokes, compared with patients who paid for their medications and had an adherence rate of slightly better than 50 percent.
“There are so many reasons patients don’t adhere — the prescription may be too complicated, they get confused, they don’t have symptoms,
they don’t like the side effects, they can’t pay for the drug, or they believe it’s a sign of weakness to need medication,” Dr.
“This is why it’s so hard to fix the problem — any measure we try only addresses one factor.”
Still, there is hope for improvement, he said.
“Nonadherence is a huge problem, and there’s no one solution because there are many different reasons why it happens.”
For example, he said parents often stop their children’s asthma treatment “because they just don’t like the idea of keeping kids on medication indefinitely.” Although a child with asthma may have no apparent symptoms, there is underlying inflammation in the lungs
and without treatment, “if the child gets a cold, it can result in six weeks of illness,” Dr. Bender explained.
“Studies have consistently shown that 20 percent to 30 percent of medication prescriptions are never filled, and
that approximately 50 percent of medications for chronic disease are not taken as prescribed,” according to a review in Annals of Internal Medicine.
When Dr. Lisa Rosenbaum, a cardiologist at Brigham
and Women’s Hospital in Boston, asked patients who had suffered a heart attack why they were not taking their medications, she got responses like “I’m old-fashioned — I don’t take medicine for nothing” from a man with failing kidneys, peripheral vascular disease, diabetes and a large clot in the pumping chamber of his heart.
Studies have shown that a third of kidney transplant patients don’t take their anti-rejection medications, 41 percent of heart attack patients don’t take their blood pressure medications,
and half of children with asthma either don’t use their inhalers at all or use them inconsistently.
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