Greatest for New Prescriptions Treating Chronic Disease
Michael Fischer, MD and colleagues followed 195,930 e-prescriptions made by 1,217 prescribers.1 On average, 22% were not even filled. The rate was highest among prescriptions for new medications treating chronic diseases: hypertension (28.4%), hyperlipidemia (28.2%), and diabetes (31.4%). A study by the insurance company Aetna found even worse primary non-adherence rates among patients recently discharged from the hospital after an episode of acute myocardial infarction. Sixty-four to forty-nine percent of those patients did not fill their prescriptions.2 Of course, filling the prescription is only the first part of adherence, so it is likely that overall non-adherence rates are much higher.
In addition to compromising patient health, the non-adherence patterns generate a considerable burden on our health care system. One-third to 69% of medication-related hospital admissions / readmissions are caused by non-adherence.3 As corporate health insurance premiums soar, an estimated 20% to 25% of those expenses stem from non-adherence.4 In 2009, the New England Healthcare Institute estimated that non-adherence costs the U.S. healthcare system $290 billion per year.5
It is possible that cost is only one, small part of the non-adherence puzzle. In the Aetna study of myocardial infarction patients, Aetna compared patients with normal deductibles for medication to patients with experimental full coverage of meds. Those with full-coverage of meds only improved their medication adherence 4% to 6%.2 However, Aetna did find even that small improvement cost-effective and embarked on plans to target certain prescriptions for lower cost-sharing.
Various strategies for improving the non-adherence epidemic have been proposed. Partnerships with pharmacies, predictive modeling, and advanced pillboxes are popular topics. When you suspect a likelihood of non-adherence from a homebound patient, a partnership with Ideal Home Care can prove productive. Whenever you prescribe a new medication, your assessment of a need for more education alone satisfies Medicare’s skilled need requirement. Various studies show nurse follow-up improving patient adherence to prescribed diets and medications.6-15
Ideal Home Care is positioned well to be your partner for improving patient adherence. Making multiple visits to the homes of your patients over the course of weeks or months, our nurses can reinforce your teaching, follow up to ensure adherence, identify barriers to adherence, and implement a variety of plans to overcome those barriers. Ideal nurses will address understanding and motivation, transportation barriers, and solutions to forgetfulness. With access to the home environment, our nurses can recruit and train family members for assistance and use the home environment to set up better, personalized reminder systems.
TOP 100 Home Health Agency
Out of all Medicare-certified home health agencies, OCS named Ideal Home Care as one of the TOP 100 agencies in the nation. TOP 100 means Ideal Home Care is in the top 1% of the home health industry. This distinction is based on better patient outcomes, better processes, and better patient and family satisfaction.
When you need home health services from an agency you can trust, consider an agency that is ranked top in the nation by industry experts.
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Ideal Home Care.