When healthcare professionals are asked to provide solutions for the disturbing rates of patient noncompliance, "No magic bullet!" is the response that gets extensive mileage. This issue, which exacts an annual $100 billion toll on the national healthcare system, is becoming a top priority for communicators and is increasingly calling for integrated strategies that target healthcare professionals and patients.
This is the multifaceted strategy the American Heart Association is using for its public awareness effort, Compliance Action Program, launched last month.
The program first targets healthcare professionals via trade publications and will focus on consumers next year.
While most healthcare organizations place a high priority on improving patient compliance, few understand all of the factors that affect it. First, consider the statistics:
- 50% of all patients, across a wide range of diseases, are not compliant with prescription treatment regimens, according to Medscape, a health Web site.
- 43% of Americans over age 50 do not fully comply with medication regimens, according to the American Association of Retired Persons.
- At least 14% of patients never fill their prescriptions, according to the FDA.
- Of the 2 billion prescriptions filled annually, almost half are taken improperly, according to the U.S. National Council for Patient Information and Education.
When it comes to getting patients to comply with their treatment plans, several barriers come into play, according to AHA, including:
- Lack of a full understanding about the importance of compliance.
- Patient concerns regarding medication side effects and/or cost.
- Inconvenience and complexity of medication regimen.
- Poor patient/physician communication.
- Patient attitude, including a fatalistic view and resistance to being controlled by a medicine or health regimen.
Providing Communication Tools
Promoting patient compliance is an area that is relatively new for nonprofit advocacy associations like the AHA. Managed care organizations and pharmaceutical companies have been the most aggressive about discussing the subject with healthcare professionals, but have had limited success. As an objective, nonprofit healthcare association, the AHA enjoys a different level of credibility with healthcare professionals, which it plans to exploit in its campaign.
The initial goal of the campaign is to provide the healthcare community with sufficient communication tools to help patients comply with medical recommendations. In targeting physicians, it's important not to insult their intelligence or to pin too much of the blame on them, says Suzanne Grant, the AHA's communication manager. A cornerstone of the campaign is the Physician's Compliance Tool Kit which provides educational materials to assist healthcare providers in teaching patients how to follow a healthy regimen. It includes the AHA's primary and secondary guidelines, a compliance poster, a patient pledge form and a patient compliance booklet called "Knock Out America's Hidden Health Threat." The kit can be ordered by calling 800/AHA-242-8721 or faxing a request to 214/706-5233.
The campaign also will use PSAs in trade publications that target physicians, pharmacists, nurses and other healthcare providers. On the PR side, the AHA is pitching story ideas that focus on why healthcare professionals need to place a higher priority on compliance issues. The AHA's Pharmaceutical Roundtable, a partnership of seven pharmaceutical companies, is funding the campaign.
(AHA, Suzanne Grant, 214/706-1467)
Nurses Play Pivotal Compliance Role
A company that has been making exciting strides on the patient compliance front is FutureHealth, a national population risk management firm in Timonium, Md., that works with more than 400 employer groups and 180,000 clients. FutureHealth, distinguishes itself from other health plan-focused disease management programs by focusing on the employer market and providing patient compliance strategies for all disease categories - chronic and acute.
By focusing on the 15% to 20% of patients in any employee group who are responsible for 80% of the health-care expenditures, FutureHealth can achieve employer cost savings of 14% in the first year. The staff develops a treatment plan for each patient in this high-risk category.
Nurses play a critical role in the patient compliance solution, says Claire Rosse, FutureHealth's founder and a nurse. A recent client satisfaction survey of 300 employees confirmed this premise. Most surveyed said:
- they were comfortable talking with a nurse; and
- they were more likely to follow the doctor's instructions as a result of the nurses' interaction.
(FutureHealth, Claire Rosse,. 410/842-1940)