Depending on the conditions for which they are being treated, up to 70 per cent of Canadian patients are not taking their medications as directed by their physicians, says a report on prescription drug trends by Express Scripts Canada.
The report – which was released April 30 and is based on statistics gathered in 2018 – underlines that patients who take multiple medications are the most likely to be nonadherent.
Regularly miss doses
"In order for medications to work, they must be taken as directed. Our benefit claims data analysis and other research shows that routinely, patients do not take medications as prescribed. They don't always finish their prescriptions and they regularly miss doses," says Dr. Dorian Lo, a physician who was appointed president of Express Scripts Canada earlier this year. "Compounding the problem, the greater the number of health challenges a patient lives with, the less likely they are to take their medications as directed."
Dr. Lo calls prescription drug nonadherence "a real health crisis" with negative effects, ranging from worsening health conditions among patients to wasted spending by patients and drug plans.
The study revealed that the more medications a patient requires, the less likely they are to follow their prescribed medication regimes. The data showed that 44% of patients who take one medication are nonadherent; 58% of patients who take two to three medications are nonadherent and 77% of patients who take four or more medications were deemed to be nonadherent to at least one of their treatments.
Nonadherence rises with severity of condition
The more severe and complex a patient's condition, the more likely they do not take their medications as directed. This is true of: 70% of plan members with asthma/COPD; 47% of plan members with cancer; 45% of plan members with diabetes and 45% of plan members with inflammatory conditions such as rheumatoid arthritis, MS and lupus, found the study.
To counter nonadherence, Dr. Lo recommends a holistic approach to benefit plan design. "Research tells us that there are many different reasons for being nonadherent, some clinical, some cost-related and some behavioural – so improving adherence requires a highly personalized approach. A 'one-size-fits-all' approach does not work."
To learn more, consult the full report.