Patient Preference and Adherence (Jul 2018)
The new landscape of medication adherence improvement: where population health science meets precision medicine
Abstract
Leah L Zullig,1,2 Dan V Blalock,1,3 Samantha Dougherty,4 Rochelle Henderson,5 Carolyn C Ha,4 Megan M Oakes,2 Hayden B Bosworth1–3,6 1Durham Center for Health Services Research in Primary Care, Durham Veterans Affairs Health Care System, Durham, NC, USA; 2Department of Population Health Sciences, Duke University, Durham, NC, USA; 3Department of Psychiatry and Behavioral Sciences, Duke University, Durham, NC, USA; 4Pharmaceutical Research and Manufacturers of America, Washington, DC, USA; 5Express Scripts Holding Company, St Louis, MO, USA; 6School of Nursing, Duke University, Durham, NC, USA Abstract: Despite the known health and economic benefits of medications, nonadherence remains a significant, yet entirely preventable public health burden. Over decades, there have been numerous research studies evaluating health interventions and policy efforts aimed at improving adherence, yet no universal or consistently high impact solutions have been identified. At present, new challenges and opportunities in policy and the movement toward value-based care should foster an environment that appreciates adherence as a mechanism to improve health outcomes and control costs (eg, fewer hospitalizations, reduced health care utilization). Our objective was to provide a commentary on recent changes in the landscape of research and health policy directed toward improving adherence and an actionable agenda to achieve system level savings and improved health by harnessing the benefits of medications. Specifically, we address the complementary perspectives of precision medicine and population health management; integrating data sources to develop innovative measurement of adherence and target adherence interventions; and behavioral economics to determine appropriate incentives. Keywords: adherence, policy, precision medicine, population health
