Medication Adherence & Impacting a Global Opioid Pandemic
Zoe Lockhart • February 6, 2023
The cost of medication non-adherence, versus the benefit of medication adherence, has been demonstrated in many studies during the past decade. In 2012, the Congressional Budget Office found that for every 1% increase in Medicare Part D prescriptions, there was a 0.2% decrease in Medicare Part A and B expenditures. With much of the available data showing benefit for adult users, researchers are now seeking to understand if this technology could also be impactful for children and adolescents. More specifically, could this technology help impact the affects noted and problems suffered from the opioid pandemic? For Dr. Renee Manworren, a pediatric pain specialist and champion of opioid stewardship, the eCAPS technology from Information Mediary Corporation (IMC) has provided a unique insight about the usage of opioid medication amongst children and adolescence.
Several studies published by Dr. Manworren have incorported IMC’s eCAPS technology to measure opioid use amid adolescents in post-operative scenarios. A strong correlation has been broadly found between the eCAPS technology and the patterned use amongst pediatric patients prescribed opioid medication. During a recent interview with HITLAB’s Chair Stan Kachnowski, Dr. Manworren highlighted the important role that medication adherence technology has played through these studies. Notably, a retrospective review published in 2018 by Billings, Manworren, Lavin, et al., found that there was a greater chance of an older child or adolescent being prescribed an opioid medication if covered by commercial insurance. During her keynote lecture in 2019 at the 48th Critical Care Congress, Dr. Manworren noted that approximately 80% of teens report opioid misuse to relieve pain, while only 35% of adolescents had an illicit intent “to get high.” From this data it is clear that a medical adherence programs, with easy to use technology, would be useful in reducing costs and improving patients’ quality of life when compared to self-reporting, which continues to remain a gold standard for many.
While many of these solutions have been shown to be effective in improving medication adherence and subsequently lowering hospitalization rates and healthcare costs, it is initially challenging to implement them. The main barrier facing their implementation is cost. According to Sloane Salzburg, Vice President at Horizon Government Affairs, it remains unclear who should take on the financial burden of medication adherence technologies. On the one hand, medication adherence could be viewed as a public health issue, and it might therefore be up to the government to fund these technologies. On the other hand, since pharmaceutical companies stand to profit from medication sales – and would benefit if patients adhered to, and continued to buy, their medications – maybe they could be the ones to invest in this area. Yet, neither party has taken on this responsibility so far.
Given the correlation between medication adherence and lower healthcare costs – not to mention improved quality of life for patients – it would be beneficial to find a way to implement medication adherence technologies. As a starting point, we can continue gathering data that verifies the economic value of such products. In doing so, we may be better able to convince institutions – like the government or pharmaceutical companies, for instance – to fund and promote them. With their support, we may finally be able to address the $300 billion problem that results from medication non-adherence.
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References
1. Billings, Kathleen, Manworre, Renee, Lavin, Jennifer et al. Pediatric Emergency Department Visits for Uncontrolled Pain in Postoperative Adenotonsillectomy Patients. Laryngoscope Investigative Otolaryngology. December 2018.
2. Manworren, Renee C. B. PhD, RN, APRN-BC, PCNS-BC, FAAN; Gilson, Aaron M. PhD, MSSW. CE: Nurses’ Role in Preventing Prescription Opioid Diversion. AJN, American Journal of Nursing 115(8):p 34-40, August 2015. | DOI: 10.1097/01.NAJ.0000470398.43930.10
