Stacey is 71 years old. She lives alone in Alabama, Georgia. She was diagnosed with Diabetes Mellitus 7 years ago and is on multiple medications for the condition. Lately, she’s been skipping several doses of her medication. Within a month, her symptoms worsened, and one day, she had to be rushed to the ER with debilitating abdominal pain and nausea. Diabetes had affected her kidneys and other organs. She was diagnosed with Diabetic Ketoacidosis, a potentially life-threatening condition.

Of course, Stacey is a hypothetical patient, but this story could well be attributed to millions of actual patients each day. Studies estimate that medication non-adherence leads to over 125,000 deaths and $100 billion in cost each year and is also one of the leading causes of death in the United States.

Stacey and many like her could avoid such life-threatening situations and the ensuing complications if the attributable reasons are identified and addressed on time.

What causes non-adherence?

While there are several potential reasons for non-adherence, in a 2005 study1, 39% of patients indicated lack of information and forgetfulness to be the reasons behind their non-adherence. In Stacey’s case, too, age-related forgetfulness was to blame.

The cost of non-adherence

As mentioned above, due to medication non-adherence, the direct losses each year have been pegged at $100 billion. The costs incurred are emergency room visits, hospitalizations, and deterioration of patients’ conditions needing further intervention and more care. Additionally, there are indirect costs with pharmaceutical companies losing out, with refills not being filled out on time. The insurance companies, employers, and even the patients have to cope with a significant co-insurance burden and an increase in premiums.

Strategies to address non-adherence

While there are many strategies to address the medication non-adherence problem, Pareto’s principle would want us to first address those that impact 39% of the population.

Interventional communication from care management teams has proven to be an effective strategy for addressing adherence issues, especially with the population where forgetfulness is the primary reason. However, with the increasing number of patients with chronic diseases who require ongoing medication use, the traditional communication outreach programs soon tend to become economically unviable. The need for qualified and trained staff further exacerbates the problem.

Cost-effective strategies

A simple and cost-effective solution that we recently built for one of our customers for medication adherence evolved from another solution that was built for an entirely different purpose. A customer, bothered by the high degree of scheduled patient dropouts, had requested us to automate their scheduling reminder process. This solution so developed turned out to be a perfect match for addressing medication adherence, albeit with some minor changes. The inspiration for automated outreach for medication adherence came from a study conducted on patients with hypertension. In this case, automated outreach reduced the cost by up to 95% compared to the traditional outreach program.

Here are the top three reasons why automated communication wins over traditional outreach:

  • Cost-effective: Traditional outreach offers multiple benefits but is expensive and places an additional burden on staff. When properly implemented, an automated communication solution can deliver the same benefits at a much lower cost. Not only that, it offers more flexibility for customizing messages, duration, and frequency according to the unique needs of patients.
  • Scalable: Addressing a large, at-risk population is also made more convenient with automated outreach, and this can be done much more cost-effectively compared to traditional outreach.
  • Easier to implement and maintain: Automated communication solutions are easy to integrate into the existing systems and do not require too much maintenance.

The solution can be configured according to the unique needs of the providers and the population that they are serving.

Our experience with our customers confirms how beneficial automated outreach can be in contributing to improved therapeutic outcomes.

 Concluding thoughts

We have seen how automated communication can help fight medication non-adherence. Perhaps, if Stacey had been part of a planned outreach from her healthcare providers, she wouldn’t have skipped her medications. Automated communication solutions can help cost-effectively address multiple challenges. The bonus for ISVs is the easy implementation and maintainability.

In the future, forging successful partnerships with payers and pharmaceutical companies can lead to a win-win situation for all the stakeholders, including the patients.

If you wish to understand how best to develop an automated communication strategy to improve medication non-adherence, please write to us at

Source: 1. 1. Osterberg L, Blaschke T. Adherence to medication. N Engl J Med. 2005; 353: 487–497 [PubMed] [Google Scholar]

Medical photo created by drobotdean –


  • Bhupesh Nadkarni brings with him over 20 years of rich experience in IT services industry with expertise in Healthcare and Manufacturing domains.

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