Ensuring the sustainability of our health care systems is a challenge preoccupying our federal, provincial and territorial governments.
Given our changing demographics, the persistent existence of poverty and social marginalization, the increasing incidence of obesity and chronic conditions like diabetes, and the simple fact that an aging population requires more care, treatment and support, the challenge can seem intractable, and the solutions remote.
In our quest for solutions to these big challenges, we can sometimes overlook the low-hanging fruit -- i.e. the small, practical changes that can bring about substantial savings and better health outcomes.
Case in point: a recent article in Forbes magazine that highlights the efforts being made in the United States to realize the cost-savings opportunities in medication adherence through incentives, health IT and data applications.
As the author notes, medication adherence is a vexing problem that has persisted since the days of Hippocrates, and it doesn't appear to be going away. In fact, the World Health Organization has established safe medication use as a priority given that an estimated 50 per cent of patients do not take their medications correctly.
But why does the problem persist, given the benefits of improving treatment adherence are so clear? Studies like the one outlined here consistently show that proper adherence to medication not only improves health outcomes for individuals, but also reduces hospital admissions and other healthcare costs which are key factors in sustaining our healthcare systems.
Perhaps the answer doesn't need to be as complicated as it might seem -- hence the low-hanging fruit. For example, something as simple as maintaining an accurate and up-to-date medication list can help patients get better results and improve medication adherence.
According to a study published in the American Pharmacists Association Journal, if a medication review is performed by a pharmacist in the first two weeks after discharge from hospital, it can reduce readmission rates by as much as 40 per cent.
In an effort to improve treatment adherence and empower patients to keep up-to-date medication lists, Canada's leading healthcare organizations are working together through a partnership called "Knowledge is the Best Medicine" (KiBM). KiBM is a consumer awareness program designed to promote healthy living and educate Canadians about the safe and appropriate use of medicines and vaccines. KiBM partners include the Best Medicines Coalition, Canadian Medical Association, Canadian Nurses Association, Canadian Pharmacists Association, Institute for Safe Medication Practices Canada, Rx&D Canada and Victorian Order of Nurses.
Since 1994, more than six million copies of the Knowledge is the Best Medicine brochure and medication record book have been distributed to Canadians in collaboration with governments, hospitals, public health agencies, patient groups and health care providers.
A recent addition to the KiBM tool kit is a free app for the iPhone and the iPad called MyMedRec. Last year, the KiBM partners developed and launched this app along with an updated website and print materials. Now available worldwide, the app allows patients and caregivers to keep better track of their medications, immunizations and other health information.
Patients can share the information via email with their family doctor, nurse, pharmacist or anyone else involved in their healthcare, as they choose. And they can do it all from the palm of their hand -- a real bonus, given the harried "sandwich" generation who must care for both their children and their elderly parents.
The app has already been downloaded by nearly 10,000 users.
The lesson in all of this, especially for those in the health community who are introducing new medicines, vaccines, diagnostic tools, imaging devices and/or patient management systems, is that new and innovative tools can only reach their full potential if the end user is considered. In other words, we need to keep asking ourselves how the tools will be used, how will results be measured, how will real people interact with these new and innovative tools? And the answers to these questions don't need to be complicated; they just need to be current.
"Vexing" health challenges can't be solved overnight, but focusing on incremental improvements to challenges such as treatment adherence can bring about positive and far-reaching benefits.