An investigation by the All-Party Pharmacy Group has once again highlighted the growing urgency to better tackle the growing problem of poor medicines adherence in the UK, which is costing the National Health Service around £100 million a year.
It is estimated that between 30% and 50% of long-term therapies are not taken properly, which not only represents a huge waste of medicines and NHS resources – given that the drugs’ bill is currently about £10 billion – but could also have potentially very serious health consequences for patients.
Speaking at a recent public meeting in the House of Commons organised by the APPG to explore the issue, community pharmacist Ash Soni said studies carried out by drug giant Pfizer showed that an astonishing 72% of patients cease taking their prescribed medicine after one year.
In the same vein, Cher Piddock, clinical lead of Asthma UK’s Care Development Team, claimed that 27%-50% of asthma patients fail to take their treatment correctly and that, incredibly, 80% of the 1,200 deaths a year from the disease can be blamed on poor adherence to therapy.
According to Professor Rob Horne, Professor of Behavioural Medicine, School of Pharmacy, who also spoke at the meeting, studies have identified more than 200 reasons why patients don’t take medicines properly, but all of these fall under one of two broad categories – they either can’t or won’t.
He believes the best way of breaking down the barriers to medicines adherence is for healthcare professionals to talk to patients about their therapy experiences, which could, for example, help to address often incorrect assumptions about related side effects.
Similarly, Soni has also called on pharmacists to become more proactive in addressing the issue of therapy compliance, and says they should make time, where possible, to talk to patients about their medications outside of the Medicines Use Review channel.
On a different note, he said that schemes put in place by pharmaceutical companies to encourage better medicines uptake were helpful, but they tend to be ad hoc and not very well promoted, while Horne stressed that before such schemes are launched patients’ perception of the industry’s involvement should be addressed, and he suggested that companies link up with third parties to help increase their legitimacy in patients’ eyes and therefore boost their success.
The APPG meeting concluded that three core areas of medicines adherence are in urgent need of improvement: the education of healthcare professionals, particularly pharmacists, so that they can be more proactive in discussing treatment with patients; giving professionals better tools to monitor and regulate adherence, including access to more comprehensive patient records; and commissioning, with widespread implementation of adherence-boosting initiatives.
“Poor medicine adherence is an extremely costly problem, and one that any incoming government will need to urgently address,” Howard Stoate MP, Chair of the APPG, has previously stressed. “By improving patients’ knowledge and approach to taking medicines, the NHS will be able to reduce wastage, reap considerable cost savings and significantly improve the health outcomes of patients,” he said, and added that as community pharmacists are experts in frontline medicine, they can play” a crucial role in helping to improve the situation”.
RPSGB Chief Executive Jeremy Holmes agrees that pharmacists are “ideally placed to support patients with information, advice and strategies to improve medicines adherence,” but he said “few primary care organisations are commissioning community pharmacy enhanced services, despite their obligation to implement clinical guidance from NICE on adherence”.
A spokesperson for the Department of Health told PharmaTimes UK News that it has recently conducted research into the extent to which medicines are not used and the reasons for this, findings fro which are expected to be published “as soon as possible after the independent peer review has been completed”.
“We have also asked NHS Employers and the Pharmaceutical Services Negotiating Committee to look into how support for people with long term conditions newly prescribed a medicine can be included in the community pharmacy contractual framework. These discussions are on-going,” the spokesperson confirmed.
