Healthcare Reform Needs Patient Adherence

While the debate rages on regarding Healthcare Insurance Reform, several key issues are either severely diminished or completely eliminated from the conversation. Many of the huge costs to the system are associated with the management of chronic illnesses, such as diabetes, asthma and heart disease. Patient compliance or adherence is one of the most critical elements of achieving improved outcomes for patients with chronic illnesses, helping to prevent costly complications and hospitalizations.

Unfortunately, the evidence regarding patient education, behavioral models, care coordinating infrastructure, and perhaps financial incentives to support patients with chronic illnesses lags behind treatment recommendations. While most health professionals are armed with myriad evidence-based clinical guidelines, little is understood or proven on how to engage patients to accept personal responsibility and become active participants in their health care.

Even a coordinated care model runs the risk of failing to achieve improved outcomes if patients do not adhere to recommendations. It is not enough for health professionals to counsel patients to stop smoking, eat a well balanced diet, get screened for markers of cancer and chronic illnesses, take their vaccines, statins, ACE inhibitors, check their blood sugar, etc. Unless there is a funding mechanism to provide the needed resources to support patients in their efforts to comply, we will continue to fail them and add to our ever-increasing cost burden to the system.

Until the system is geared up to support patients and caregivers with the best tools to accept more personal health responsibility and adhere to proper proven recommendations, we will continue to have sub-optimal outcomes no matter what we spend or recommend for healthcare reform changes.

Mike Toscani, PharmD
Project Director
Jefferson School of Population Health