Up to half of patients do not take medication as prescribed

Up to 50 per cent of patients with serious long-term medical conditions do not take their medication or take it incorrectly, a roundtable event on medication compliance and adherence in Dublin heard last week.

European research has estimated that 20-30 per cent of patients do not adhere to medication regimens that are curative or relieve symptoms, while 30-40 per cent fail to follow regimens designed to prevent health problems, with results for long-term medication worse at about 50 per cent compliance.

Complex issue
The reasons for poor medication adherence are complex, a number of speakers told the meeting, and include cost, poor communication and education about the medication from healthcare workers, as well as fear about side effects and lack of awareness about the risks to health if the medication is not taken.

Prof Frank Doyle, a lecturer in psychology in the Royal College of Surgeons Ireland, said routine, social support and emotional factors all play key roles in medication compliance, with, for example, depressed patients less likely to take their medications.

Dr Colm Galligan, medical director of MSD Ireland, said one in four Irish patients has poor levels of health literacy, which is directly linked to health outcomes, while Eibhlin Mulroe, the chief executive of Irish Platform for Patients' Organisations, Science and Industry (IPPOSI), said health numeracy could also be an issue, with some patients not understanding their medication needs to be taken a certain number of times per day and at set times.


Dr Roisín Adams, the deputy head of the National Centre for Pharmacoeconomics, noted that medication compliance and adherence had a key impact on treatment cost-effectiveness and supported calls for more research on why patients do not take their medication.

She quoted a number of different studies highlighting poor long-term treatment adherence in breast cancer, osteoporosis and diabetes medication, causing poor outcomes and more costs to the health system.

Prof Ken McDonald, consultant cardiologist, St Vincent's University Hospital, Dublin, said patients were more likely to take their medication after an acute event, such as a heart attack, but as time goes by are less dedicated to taking their "life-saving medications".

Cost to State
Chief operations officer of the HSE Laverne McGuinness said the issue was one that it was keen to address, given the "huge" cost of the State's drugs' bill at about €2 billion per year.

The roundtable was hosted by IPPOSI and was addressed by Department of Health secretary general Dr Ambrose McLoughlin who said new prescribing guidance would be issued to doctors later this year. He also confirmed the long-awaited Health Information Bill would be published by the end of October.