May 7, 2012
Comments submitted by the National Consumers League to the Department of Health and Human Services, Office of the Surgeon General
Washington, DC--The National Consumers League (NCL) developed and is leading Script Your Future, the first campaign to raise awareness among consumers, family caregivers, and health care professionals (HCPs) about the importance of taking medications as directed. Because of the variety of factors contributing to poor adherence and the complexity of the issue, a comprehensive, integrated campaign with broad public and private stakeholder cooperation is needed to provide consistent messaging and support to the consumer and HCPs.
The three-year campaign, which launched in May 2011 with more than 100 Partners, focuses on patients affected by three of the most prevalent chronic conditions—diabetes, respiratory disease and cardiovascular disease. The campaign includes a national communications initiative and targeted outreach in six pilot cities – Baltimore, Birmingham, Cincinnati, Providence, Raleigh, and Sacramento.
To develop the campaign, NCL reviewed existing research and conducted a series of focus groups and interviews with consumers, HCPs, and family caregivers, to understand attitudes and beliefs about medication adherence, including reasons for poor adherence, and input on messages to promote adherence.
A common thread of communication resonated across patient types in the focus groups. Many patients do not understand their diseases or the consequences of not adhering to a medication regime, and may not recognize the benefits of their medications. Patients responded to the use of direct, factual language to detail the consequences of non-adherence, such as serious health complications and a restricted quality of life, as well as impact on family. While the reasons for non-adherence were varied - including the complexity of managing multiple medications, side effects, no discernible impact, and cost - realizing the consequences of non-adherence resonated with all patients.
Based on the research, Script Your Future is using direct language about the consequences of non-adherence, and provides practical tools and online resources that help patients and HCPs better communicate about ways to improve medication adherence.
Periodic public opinion research both at the national and regional level is used to inform and evaluate the campaign. A national survey of 1302 adults and a survey of 1800 adults in the targeted cities conducted before the 2011 campaign launch found that:
- Those who do not “always” adhere are less convinced of the importance of adherence and less likely to have had the consequences of not adhering fully explained.
- Patients express a high willingness to ask questions and raise concerns about medicines with a HCP, but when asked directly, many admit communication is infrequent.
- Patients view question lists, automatic refills, reduced co-pays, and pill boxes as the most useful tools to improve adherence
These survey findings confirm the campaign’s emphasis on communicating the consequences of poor adherence, promoting conversations between HCPs and patients, and providing practical tools to support adherence.
It is important that government continue to play an active part in the improvement of adherence, as this multi-faceted issue does not have a single organization “owning” the problem nor a single solution, thus requiring all stakeholders to come together and work collaboratively.