CAREGIVERS NEED SPECIAL ATTENTION, EDUCATION
AND SUPPORT IN PROPER USE OF MEDICATIONS
Patient Education Can Reduce Soaring Health Care Costs

Washington, D.C.--As more health care takes place in the home, doctors and pharmacists are beginning to realize that the key to cost-effective therapy is proper use of medications by patients and caregivers.

"More attention must be given to `the transfer of power' that occurs when a medication is dispensed to a patient or caregiver," Dorothy L. Smith, Pharm.D. and president of Consumer Health Information Corporation told participants at the National Council on Patient Information and Education (NCPIE) Invitational Conference.

"Patients and caregivers are making critical day-to-day decisions regarding the patient's prescription regimen. But the fact is that up to 20 percent of all initial prescriptions written by physicians are never filled by patients, and of those that are filled, 50 percent are taken incorrectly. Furthermore, 30 percent of all refill prescriptions are never refilled."

"Patient education services could help save the U.S. nearly $100 billion a year in health care and lost productivity costs by improving prescription medication compliance and treatment outcomes," Dr. Smith said. "It makes no sense to continue paying for medical complications resulting from patient/caregiver mismanagement of medications when they can be prevented with patient education programs."

In her presentation, Dr. Smith emphasized the importance of reaching three types of patients– children, working adults and the bedridden–as well as caregivers. With 25 million caregivers, both in U.S. health care institutions and in individual homes, spending an average of 18 hours a day providing care, health care costs will continue to rise unless programs are developed to effectively reach them.

"There needs to be more involvement–more personal attention–provided by doctors and pharmacists throughout the entire prescription therapy process to ensure medication compliance," said Dr. Smith. "While the cost to provide individualized patient/caregiver education can be high, the significant savings due to improved medication compliance are far greater."

Dr. Smith presented several recommendations and examples of how patient/caregiver management of medications can be dramatically improved:

• At the time of the initial prescription, health professionals must explain the medical condition and also the reasoning and value of the recommended drug therapy in terms that can be understood by both the patient and caregiver.
• At every follow-up visit, the prescription instructions should be reinforced by health professionals. The patient's progress in drug therapy should be monitored and any complications the person is having should be managed.
• Patients need printed materials that are practical and in language they can understand to reinforce what their doctors and pharmacists have recommended. At the same time, written instructions should never be used as a substitute for personalized counseling.
• To free up time to provide individualized patient counseling, health professionals must be able to delegate appropriate tasks and also be reimbursed for such counseling.
• To delay or prevent institutionalization of bedridden patients, health professionals should individualize the drug regimen to the needs of the patient/caregiver, including compliance-packaging of medications, prescribing medications with simplified dosage regimens and compliance reminder aides.
• Consumer awareness programs should be developed to reinforce the roles of the patient/caregiver, pharmacist and physician in the drug therapy.

Dr. Smith also noted that consumers and patients/caregivers need to realize that becoming or staying well is not a passive process. She emphasized that individuals have the responsibility to actively seek information, ask questions and to understand the responsibilities of drug therapy.