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New medicine service

Patients twice as likely to continue taking medicines if warned about health impact of non-adherence

Patients who are warned about the personal health consequences of not taking their medicines are nearly twice as likely to continue taking them as prescribed, research has found.

Researchers from Boots, UCL, and Columbia Business School, New York — funded by the Department of Health and Social Care — have found that patients are significantly more likely to continue taking their medicines as prescribed if they are asked to sign a commitment to do so that highlights the health consequences of non-compliance.

The study recruited more than 12,000 patients across 249 Boots stores over eight months. The researchers first aimed to understand why patients fail to adhere to their prescriptions, before testing different behavioural “nudges” to find the best ways of boosting concordance.

As part of the study, the patients were randomly divided into four groups and asked either to sign a sticker highlighting personal health costs of non-adherence (2,495 patients) or financial costs (2,239 patients), a simple commitment to taking the medicine (3,213 patients) or not signing a sticker at all (2,789 patients). The sticker was then affixed to the medicine packaging.

For the purpose of the study, the practice of signing the stickers formed part of the NHS New Medicines Service (NMS) for patients with long-term conditions when patients picked up prescriptions for the first time from their local pharmacy. The NHS first launched the NMS in October 2011, with more than 90% of community pharmacies in England now providing the service.

Patients in the group who signed the sticker highlighting the personal health costs of not completing their course of medication “had 1.82 times higher odds of adhering to their medication than patients across the three comparison conditions”, the study results show.

According to an international review by the Cochrane Collaboration, only around half of medicines for long-term conditions are taken as prescribed in developed countries, which is having an increased impact on public healthcare costs and people’s health.

Marc Donovan, chief pharmacist at Boots, said this study was important in looking at how community pharmacy can take the lead on non-concordance “by using simple behavioural nudge theories, ultimately helping make important services like the NMS more effective for patients as well as saving the NHS money”.

Boots is also working with researchers at University of Nottingham to understand more about nudge messages and how they could be introduced into wider community pharmacy practice.

Citation: The Pharmaceutical Journal DOI: 10.1211/PJ.2019.20206359

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