Leveraging Social Health to Solve Adherence and Compliance Challenges

Published February 23rd, 2022 | 5 Minute Read

Medication nonadherence is a common and costly challenge for patients. It’s estimated to affect as many as 40-50% of patients prescribed medications to manage chronic conditions, such as diabetes or hypertension.

While nonadherence is a year-round challenge, winter is an especially challenging time for patients who often face formulary plan updates, deductible resets, and the impending threats from cold and flu season. Combined with the impact of life during a global pandemic, it can feel overwhelming to navigate all of the twists and turns of managing a chronic condition. 

The healthcare industry has made great strides toward improving medication adherence and compliance, but challenges and barriers still exist, and it’s a shared responsibility between patient and provider to overcome. 

Within the limited time constraints of an appointment, doctors balance educating patients around medication use, efficacy, side effects and alleviate concerns. Conversely, patients must come prepared to their appointments with any questions and concerns and have a support system ready beyond the walls (or screen) of the doctor’s office to ensure that they remain compliant and adherent to treatment plans. 

Somewhere within this tangled web of imperatives lie points of disconnect, otherwise, adherence and compliance would be a non-issue. Where are those points, and what can be done to close those gaps? 

The Disconnect between Perceived Behavior and Reality Gaps Exist within Patient/Doctor Conversations

A Health Union survey on self-reported Retention, Adherence, and Compliance, fielded during August and September 2021, identified key points of disconnect between the perception of adherence and compliance versus the reality.

Of the 1,945 respondents*, 82% stated that they felt adherent to their treatment plans. However, in the same survey, half of the respondents also reported not taking their medications on schedule in the past two years.  

Another disconnect is that nearly one-quarter (24%) of patients reported stopping taking a prescription without talking with their HCP first. Of those who have stopped taking medications, 31% of patients reported that they had stopped taking the medication without a replacement.

The list of reasons for stopping a medication without provider guidance is robust, yet the survey found many of them are not being discussed in the office visit, causing an inverse relationship between HCP conversations and patients’ challenges in staying on medication. While medication instructions, side effects, and dosing information are critical and generally a healthcare provider’s focus during patient interactions, there’s a missed opportunity to address other issues patients cite as leading to some of their challenges, such as insurance coverage and cost. 

Interesting inverse relationship of HCP conversations and the challenges patients face with their treatment plan

“It is clear that HCPs do an excellent job addressing necessary concerns about why, how, and how often patients should be taking needed medications and treatments,” said Olivier Chateau, Health Union’s co-founder and CEO. “It is likely these conversations have mitigated certain challenges to adherence and compliance. However, this survey data also shows that there needs to be a more concerted effort – from both HCPs and healthcare companies generally – around discussing cost and financial access to treatments.”

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Survey: Treatment Plan Discussions Differ from Adherence Challenges

With the highest percentage, 27% of respondents said they viewed cost as a challenge to staying on their medication as prescribed or instructed.

Challenges and Barriers are Situational

Address Challenges and Barriers Throughout the Patient Journey 

It would be simple if there were one blanket reason for these challenges and barriers, but the reality is that the reasons for nonadherence and noncompliance are situational, and thus there is not a one size fits all solution. However, we can glean insights around the critical points along a patients’ journey where nonadherence and noncompliance might come into play. 

Our research identified some themes based on points within the patient journey, which may help healthcare providers, payers, and pharmaceutical companies understand where the barriers may lie.

At the beginning of a patient’s prescription journey, of the quarter of patients who chose not to fill a new prescription, 57% cited that financial and/or insurance issues were the reason.

Reasons for Not Filling Prescription

Health Union’s online community model demonstrates the everyday challenges patients face in making treatment decisions when facing difficult financial situations.  

Comments from Health Union Community Members

Once patients have the prescription in hand, the challenges shift from financial to behavioral and emotional. The perception and experience of side effects plays a leading role in whether patients will start and stop therapy.

In some cases, patients will choose not to start therapy due to the fear of impending side effects. Of the 12% of patients who reported filling a prescription but never taking it in this survey, 53% reported that fear of side effects is what held them back.

And as it relates to stopping a medication, 48% (of the 31% of patients that stopped taking medication) cited it was due to actually experiencing side effects.

Reasons for Not Taking a Filled Prescription

According to our data, once patients are on medications, they do their best to stay on. The charts below illustrate that 8 of 10 patients surveyed used at least one tactic to help them remember to take their medication according to schedule, many of which are reminders.

Tactics Used to Remember to Take Medication & Most Successful Tactic for Remembering

Even so, remembering to take medication is a challenge, and half of patients reported to have missed their medication on schedule in the past two years with forgetfulness topping the list (87%) as the leading reason.

Post Prescription Script Fill Actions Over the Past 2 Years

Comments from Health Union Community Members

Polypharmacy Presents Additional Challenges

In the United States, it’s estimated that 44% of men and 57% of women ages 65 and older are regularly using at least five medications (polypharmacy). 

Within this survey, which included 1945 patients across 48+ different conditions, the average number of medications being used was 7 (most commonly orals), which indicates that the survey patient population was largely comprised of polypharmacy patients.

Number of Different Prescription Medications or Treatments Currently Using

According to these patients, as the number of medications taken increases, perceived ease of following one’s treatment plan decreases, which presents an added burden.

Current Treatment Plan Easy to Follow by Number of Current Medications (Rated 6 or 7)

Reaching Patients Where They Are through Social Health 

The insight gleaned from this survey is that while chronic condition patients, often on a polypharmacy regimen, face substantial challenges to adherence and compliance, they are still motivated and take action to remain compliant on their treatment plans. And while conversations are still happening within the walls of the doctors office, there are real disconnects and gaps in education around adherence and compliance that must be addressed elsewhere.  

Community Member Blog Title and Blurb

Leveraging social health, the dynamic, real-time actions people take to find meaningful connections and share information throughout the health journey, as a tool to fill these gaps with the right message in the right moment at the right time, will help drive smarter, more effective health decisions. 

The beauty of reaching and educating these chronic condition patients through social health, is that patients are actively engaging and seeking new solutions already through social health, the conversations are happening in real time as challenges arise.

Whether it’s advertising cost savings programs, safety profile FAQs, nurse navigator, and patient support programs, these are all topics that are already being discussed in online communities and on social media. These resources and solutions are highly relevant and shareable through social health.

Building Patient Trust through Social Health

The patient journey is not linear, nor are the challenges of adherence and compliance. However, by partnering with patients on adherence and compliance initiatives and being present within social health during the moments when people need it most, brands can show that they understand and build credibility within patient communities.

Partner with Health Union to expertly navigate the expansive world of social health – from scalable online health communities and social extensions to comprehensive quantitative condition-specific data and more. 


*Patients who were living with a chronic health condition who were currently using at least one medication – either prescription or OTC

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