The 'cost' of medication nonadherence: consequences we cannot afford to accept.

OBJECTIVE: To provide a brief overview of the extent of medication nonadherence in the United States, its impact on patient health and health care costs, its causes, and possible strategies that health care practitioners can use to improve medication adherence.
SUMMARY: Medication use and health care costs have increased dramatically during the previous decade in the United States. Adherence to medication therapy often is a critical aspect of medical treatment, particularly the treatment of chronic conditions such as diabetes and hypertension. Despite the importance of adherence, medication nonadherence is a serious problem, with the World Health Organization noting that the average nonadherence rate is 50% among those with chronic illnesses. Consequences of nonadherence include worsening condition, increased comorbid diseases, increased health care costs, and death. Nonadherence results from many causes; therefore, no easy solutions exist. The first step to addressing nonadherence is to recognize that collaboration must occur between health care practitioners and patients to increase adherence, with the goal of achieving optimal health outcomes.
CONCLUSION: The relationship between health care practitioners and patients and open, ongoing communication between the stakeholders are essential to combating medication nonadherence. Given their training and accessibility, pharmacists are well positioned to address nonadherence.