Senior Alternatives

Care Management and Home Care Services
Compliance and Medication Management

December 28, 2011

One of the challenges we see with medical professionals in geriatric care is the lack of compliance and adherence to medication management.  We often hear from our physician partners and families of the frustrations of their patients and loved ones who struggle with medication management and keeping with treatment protocols because of confusion or forgetfulness.  This can often lead to more serious problems if not managed correctly.

According to a study on Medication Regimens from the Department of Health and Human Services, the Office of Inspector General, failure to adhere to medication instructions, either willful or inadvertent, has been termed noncompliance with medication regimens. Instances of noncompliance can include failing to initially fill a prescription, taking either more or fewer doses than instructed, and taking medications that have been prescribed for someone else. Current research indicates that 55 percent of the elderly do not follow the medication regimens prescribed by their physicians.

Most non compliant patients fall into 4 categories:

  1. Physiological factors: Loss of vision or hearing can impede an elderly person’s ability to read important information about his prescription or to hear instructions about his regimen.
  2. Behavioral factors: These include social isolation, social and health beliefs, and economic condition. Many elderly people live alone. Studies have shown that people who live alone more often fail to comply with medication regimens.
  3. Treatment factors: These include the duration and complexity of the medication regimen. Compliance rates decrease when the treatment is long-term and when the regimen includes many different medications that must be taken concurrently.
  4. Health Care Provider / Patient Interaction factors: These include how well the physician, the pharmacist, and the patient communicate with each other. The quality and content of a physician’s instructions, the content of a pharmacist’s label, and the ability of a patient to ask questions can all affect compliance.

The consequences of noncompliance are serious and costly. Noncompliance with medication regimens can result in the increased use of medical resources such as nursing homes, hospitals, physician visits, and unnecessary treatment. Noncompliance with medication regimens may also result in therapeutic failure. For example, missed doses of cardiac anti-arrhythmics can lead to arrhythmia and cardiac arrest.

Our Care Managers and Care Givers skillfully manage non-compliance issues and can get a patient back on track through education and support.  On a daily basis, they assist in medication management to increase medical compliance and improve patient outcomes by providing consistent, daily support.  They explain why it is so important to take medication as prescribed by the doctors and what could potentially happen if it’s not taken and how it can affect their health.  There are tools such as a daily medication reminder pack where you can place all of the medication needed for the day into an organized container, this alleviates thinking about what to take and when. Also being able to provide a daily caregiver to help with the medication reminders and to provide support for other areas of concern will help take the burden off of the patient.  The use of communication is the key and by implementing a team approach between the patient, the doctor and any family members will provide support and get the patient on track.  To read the full report on Medication Regimens; Causes of NonCompliance from the Department of Health and Human Services, visit http://oig.hhs.gov/oei/reports/oei-04-89-89121.pdf.

Noncompliance with medication regimens can result in the increased use of medical resources such as nursing homes, hospitals, physician visits, and unnecessary treatment.

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