Medication non-adherence: a barrier to progress in treatments for chronic conditions?

Worldwide, nearly half of the adult population and approximately 8% of children live with a chronic condition, such as cancer. Medications can be a cost-effective treatment for chronic ill-health, however, it is estimated that 50% of those living with a chronic disease do not adhere to their medication regime – including the amount, timing, and frequency of medication dosage.

Medication non-adherence is a significant medical concern: it is associated with low survival rates, disease progression, reduced functional ability, increased risk of hospitalisation, and lower quality of life. Annually, there are approximately 250,000 hospital admissions related to medication issues, including medication non-adherence.

Medication non-adherence is also costly – and that cost is growing. The use of oral medication has increased, as has government and patient spending on prescription medicines. In 2020-21, the Australian government spent 5% more on subsidised medicines compared with the previous year, which was already 2% higher than the average yearly growth since 2015. In 2015, consumers spent AUD$ 3.2 billion for prescription medicines. For hypertension, dyslipidaemia and depression, medication non-adherence cost AUD$10.4 billion per year, equivalent to $517 per Australian.

If medication non-adherence could be effectively addressed, it would lower this economic burden on the health system. For instance, compared to non-adherent patients, patients who did adhere to their medication regime cost less in hospital admissions (62.0%), emergency (45.0%), outpatient visits (13.0%), and overall total healthcare costs (49.8%).

And yet, despite the seriousness and cost of medication non-adherence, promoting adherence among patients is not consistently part of routine medical care, and efforts to address it have been fragmented. While a growing number of medication adherence interventions are being trialled, their effectiveness is yet to be established.

An emerging tech solution?

At Peter MacCallum Cancer Centre and Swinburne University of Technology, researchers, healthcare professionals and patients have co-designed a digital solution to medication non-adherence, named SAMSON, including a SAMSON app and a motivational interviewing training platform. The SAMSON app is intended to provide patients daily drug dose reminders, weekly symptom surveys, access to medication information, and self-care advice to manage drug side effects. The app also helps the treatment team to monitor patients’ adherence and assess their symptoms in real-time, and remotely – something that matters to patients and medical staff in regional and remote areas of Australia. The online training platform upskills healthcare professionals in communication and motivational interviewing – an evidence-based approach to behavioural change that has been proven to be effective in treating various health problems. The patient’s app data allows healthcare professionals to tailor teleconsultation conversations and apply those motivational communication skills to provide patients with ongoing support to maintain long-term adherence and to promote their drug self-management behaviour, thus avoiding hospitalisation.  

SAMSON solution is about to undergo a clinical trial to establish whether it is acceptable, feasible and potentially effective at improving medication adherence. If it proves to be successful, then there may be a suitable tech solution to address the current challenge around medication non-adherence and thus reducing the burden on the health community in Australia – reducing hospitalisation numbers and the share of taxpayer dollars spent on treating chronic disease.

Interested in medication adherence interventions in cancer? Click here to read more.

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