Staying on Track: Why Medical Adherence Matters in Chronic Condition Management

We’ve all heard the phrase “doctor’s orders,” from a family member or friend reminding us to eat healthy or take our medicine. But it’s not a catchphrase. The advice a doctor provides is a real plan tailored to make patients feel better, stay healthy, and avoid complications down the road.

Medical adherence, or patient compliance, is the scale on which patients follow their recommended treatment plan, including taking medications as prescribed, scheduling necessary care, or making certain lifestyle changes.

Chronic conditions such as diabetes, heart disease, arthritis, and high blood pressure affect more than 130 million Americans and cause seven out of every ten deaths in the United States each year. They also account for the fastest-growing cost category in health care, comprising over 86% of all healthcare costs. Patients with chronic diseases require strict medical adherence to effectively manage their conditions, including regular medical attention and consistent medication regimens. Yet for a variety of reasons, many patients don’t fully adhere to the medical advice they’re given.

Fortunately, AssuredPartners can help employers promote better medical adherence across their workplace. Doing so not only creates a healthier, more motivated employee base, it also reduces unnecessary healthcare costs, leading to more savings for employers and employees.

Medical Adherence

Without consistent medical adherence, treatment plans can have a higher chance of failing and conditions may worsen. In addition, inconsistent treatment can lead to complications or other conditions that could have been avoided. These can eventually lead to cost increases for the employers’ health plan, which may, in turn, lead to employees needing to pay more for their portions or premiums or visits.

It is in an employer’s best interest to help employees properly navigate their health plans to best manage their chronic conditions to avoid unnecessary complications and medical bills.

When is Medical Adherence a Problem?

Unfortunately, many Americans do not consistently adhere to recommended medical treatments or take medications as prescribed. There are several possible reasons for this. One may be the out-of-pocket costs that the patient must pay. Medical care and medications for chronic conditions can be quite expensive. Another reason may be a lack of knowledge and education on the impact these treatments have. Any patient that does not fully understand a disease, why treatment or medication is essential, or the consequences of not following through on treatment may be less likely to consistently seek treatment and take medication.

Pharmacy’s Role in Condition Management

Disease management is becoming much more prevalent in pharmacy strategies as well. Pharmacists are no longer limited to dispensing medication and safeguarding the distribution of drugs.

Instead, many pharmacists are now actively involved in the collaborative management of patient diseases such as diabetes, congestive heart failure (CHF), chronic pain, asthma, HIV-AIDS, and more.

Pharmacy involvement in disease management can include patient education, therapeutic drug monitoring, laboratory testing and interpretation, and initiating and modifying medication regimens based on clinical assessments. This growing trend, known as “pharmaceutical care,” is enhancing the status of the pharmacist as a provider of specialty health care. As pharmacy costs continue to rise for many employers and often have a significant impact on bottom lines, special attention is being paid to the strategy behind pharmacy strategy and communications sent to educate employees.

Following the Doctor’s Orders

Given that many diseases are curable, preventable, or treatable, encouraging employees to follow medical professionals’ orders is vital for achieving and maintaining good overall organizational health. Patients who do not follow their doctors’ orders, especially patients with chronic conditions, may experience further health complications, rapid disease progression, and decreased quality of life. All of these can bring further expenses for both the employee and the employer.

What Can Employers Do?

Employers can play a big part in helping their employees adhere to their medical treatment plans and medication regimens. These are just some of the ways employers can encourage better compliance:

• Offer value-based incentives: One way to increase adherence is to lower copays for medication. This can help combat the high cost of managing a chronic condition.
• Provide Online Search Tools: Online healthcare search tools including those that help find in-network providers or help evaluate medication prices at various pharmacies can provide employees the central source they need to evaluate the care options available to them.
• Educate employees on their chronic conditions: Provide employees with educational materials so they understand the importance of medication and treatment, along with the possible consequences of inconsistent medical adherence. This can mean a series of educational videos, in-person lunch and learns, home mailers, or other communications methods to reach the members of the plan.
• Add a worksite health clinic or pharmacy: While this solution is not feasible for all employer sizes, these clinics can help reduce their health care costs and make seeking medical attention more convenient for all employees. Managing a chronic illness is time-consuming and overwhelming, so providing access to care at the workplace makes it much easier for employees to seek treatment.

Studies consistently show that patients who are more informed and receive consistent communication about the importance of their treatment are more likely to be medically adherent. At AssuredPartners, we’ll work with your organization to create strategies that promote medical adherence within your employee population. Reach out to your AssuredPartners team to get the conversation started today.