Sharing responsibility in medication management

The rise in chronic disease along with patients needing long-term medications is due at least in part to the progressively ageing populations and means health systems must find better ways of caring for patients.

Clinician-patient partnerships are a particularly important way to achieve this, as educating patients on their condition and motivating them to play an active role in their care empowers them to make healthier choices and decisions. This concept is variously described as patient activation and “emphasises a patients’ willingness and ability to take independent actions to manage their health and care.” [1]

Trusting and enabling patients safely to take ownership of aspects of their care will assist clinicians in sharing responsibility with patients. Medication management is a good example of an area in which patients can be encouraged to take a major role in the way their care is managed.

Encouraging patient medication adherence

Patient non-adherence to their medication regimen is an ongoing problem for clinicians and healthcare systems. The economic impact of medication non-adherence has been estimated at a cost ranging from US$100 to $290 billion in the United States [2].

There are many reasons for patient medication non-adherence including some of the following: a lack of understanding and knowledge of their medication regime, lack of input into the decision making, a belief the medications won’t work, adverse side-effects and lack of communication between clinicians and their patients.

Studies have shown that the best interventions to encourage medication adherence involve enhanced support from family and the care team including allied health professionals such as pharmacists, plus education, counselling and daily treatment support [3]. Clinicians should work to establish a partnership with patients based on trust and a shared understanding of the clinical problem and the part medications can play in its solution.

The example of patient medication adherence touches on many of the points we have discussed throughout this series and provides a very specific and important example of why forming effective clinician-patient partnerships is such a crucial part of any treatment plan.

Sharing of responsibility enabled via technology

Many studies have shown that patients view themselves as being responsible for their own health provided this is in close collaboration with their care providers [4, 5]. It is clear there is a willingness by many patients to take ownership over aspects of their care.

Tools such as an integrated medicines platform made available in the provider view and the patient view provide authoritative medication lists, a medications timeline and a single source of truth for all medication data. This enhances communication across the patient’s care team (always including the patient themselves), via a holistic understanding of their medication regimen.

Providing patients with access to a medicines platform allows them to view an up-to-date and accurate list of their medications. In addition to access, patients should be able to make comments about their medication adherence and any over the counter medications.

Not only does use of a medicines platform encourage medication adherence, but it puts some responsibility back onto the patient to take control of their medication regimen. In collaboration with their care team, patients can be entrusted safely to manage their medication, an important aspect of their condition.

How can Orion Health help?

Orion Health’s integrated Medicines platform provides a complete patient-centric solution for the management of medications at all points of a patient’s journey. It is seamlessly integrated with both the provider portal, the patient portal and our FHIR APIs.

Our Medicines platform is where all medication information is assembled and organised in an easy-to-understand format. Our technology takes care of most of the work by semantically organising the information in a way easy for clinicians to understand and work with.

By simplifying the task of understanding what medications a patient is taking, what medications they should take going forward and sharing that information across the care team (including the patient), the effort required by both the care team and the patient is lowered.

Interested in learning more about how our Medicines platform can help you and your patients?

This blog is the fifth and final in the series of blogs on partnering with patients.

Read our previous blog on The importance of sharing information to support quality patient care.

References

[1] Hibbard, J. H., & Greene, J. (2013, February 01). What The Evidence Shows About Patient Activation: Better Health Outcomes And Care Experiences; Fewer Data On Costs. Retrieved September 30, 2020, from https://www.healthaffairs.org/doi/10.1377/hlthaff.2012.1061

[2] Cutler, R., Fernandez-Llimos, F., Frommer, M., Benrimoj, C., & Garcia-Cardenas, V. (2018, January 21). Economic impact of medication non-adherence by disease groups: A systematic review. Retrieved October 01, 2020, from https://bmjopen.bmj.com/content/8/1/e016982

[3] Nieuwlaat, R., Wilczynski, N., Navarro, T., Hobson, N., Jeffery, R., Keepanasseril, A., Agoritsas, T., Mistry, N., Iorio, A., Jack, S., Sivaramalingam, B., Iserman, E., Mustafa, R. A., Jedraszewski, D., Cotoi, C., & Haynes, R. B. (2014). Interventions for enhancing medication adherence. The Cochrane database of systematic reviews, 2014(11), CD000011. https://doi.org/10.1002/14651858.CD000011.pub4

[4] Ham, S., Prof, Charles, A., & Wellings, D. (2018, November 23). Shared responsibility for health. Retrieved September 30, 2020, from https://www.kingsfund.org.uk/publications/shared-responsibility-health

[5] Burkitt, R., Kate Duxbury, K., Evans, H., Ewbank, L., Gregory, F., Hall, S., . . . Wenzel, L. (2018). The public and the NHS What’s the deal? (pp. 24-25, Rep.). London, UK: The King’s Fund. doi: https://www.kingsfund.org.uk/sites/default/files/2018-06/The_public_and_the_NHS_report_0.pdf