Medication non-adherence has far-reaching consequences, affecting both patients and the pharmaceutical industry. Patients who do not adhere to their prescribed medications face higher mortality rates(1), increased hospital admissions, suboptimal health outcomes and greater morbidity(2).
Financially, it results in substantial losses for pharmaceutical companies. In the United States, non-adherence leads to an estimated $290 billion in avoidable medical spending annually(3).
In this study, we sought to understand medication compliance challenges for different conditions and consumer segments across Asthma, Depression and Type 2 Diabetes (T2D) patients
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Methodology
Using a blended quali-quant approach, we looked into patient experiences, behaviors, motivations and perceptions to uncover nuanced insights, revealing the "why" behind the data.
Compliant Patients
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Across conditions, patients reported a variety of strategies and motivators that encourage them to take their meds as prescribed.
Strategies
Motivators
Non-Compliant Patients
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A few themes emerged when we asked patients what barriers prevent them from taking their medication as prescribed.
Attitude Barriers
Behavioral Barriers
Emotions toward taking medication & compliance - a complex relationship
We asked patients how they felt about taking their medications, and then went one level deeper into sub-emotions using emotion charts. Overall more compliant patients report more positive emotions about taking their medication (proud, trusting) while less compliant patients report more negative feelings about taking their medication (ashamed, self-conscious, angry).
Asthma
For Asthma patients, dominant emotional themes toward taking medication were trusting, proud and joyful with sub-emotions of secure, assured, and excited.
Depression
For Depression patients, dominant emotional themes toward taking medication were ashamed, sad and trusting with sub-emotions of self-conscious, embarrassed, and hopeless. Patients feel the social stigma around taking depression medication intensely and it is a large emotional influence. On the flip side, there is also hope that the medication will help them feel better.
Type 2 Diabetes
For T2D patients, dominant emotional themes toward taking medication were sad and angry with sub-emotions of disappointed, miserable, and frustrated.
With T2D, we see that the heavily negative dominant emotions don't necessarily equate to non-compliance. These patients reported always taking their medication as prescribed at higher rates than either of the other two conditions. This is likely due to the severity of possible negative health should the patient fall out of compliance.
Key Takeaways
There are many reasons a patient may be non-compliant with top reasons being:
- Too busy, ok to skip a dose sometimes (especially Asthma)
- Forget to take, want to avoid side effects, didn’t feel like it was working (especially Depression)
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T2 Diabetes patients are slightly more compliant than Asthma and Depression patients
Patients are inspired to comply by a desire for improved physical and mental health, their families, friends, communities, and careers. They use a variety of strategies to comply including:
- Leave visible/in certain spot (especially Depression and T2D)
- Pill organizer (especially T2D)
- Alarm
- Incorporate into routine (especially Depression)
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Auto-refills
Emotions toward taking medications can be complex and depends on condition. Asthma patients feel overall positive about taking their medication, but Depression and T2D patients feel more negative about taking their medication.
On the whole, we found that more compliant patients report more positive emotions toward taking their medication and less compliant patients report more negative emotions toward taking their medication.
1. Van Alsten SC, Harris JK. Cost-Related Nonadherence and Mortality in Patients With Chronic Disease: A Multiyear Investigation, National Health Interview Survey, 2000–2014. Prev Chronic Dis 2020;17:200244. DOI: http://dx.doi.org/10.5888/pcd17.200244
2. Neiman AB, Ruppar T, Ho M, et al. CDC Grand Rounds: Improving Medication Adherence for Chronic Disease Management — Innovations and Opportunities. MMWR Morb Mortal Wkly Rep 2017;66. DOI: http://dx.doi.org/10.15585/mmwr.mm6645a2.
3. New England Healthcare Institute, Thinking Outside the Pillbox: A System-wide Approach to Improving Patient Medication Adherence for Chronic Disease. August 12, 2009
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