A prescription for better medication adherence

Patients don't always take their medicine, even if it's free. That stubborn fact has been tied to 89,000 premature deaths and more than $100 billion a year in avoidable hospitalizations, researchers estimate.

The reasons why people don't follow their medication regimens are less clear, making it hard to come up with solutions. In a commentary published online today in the New England Journal of Medicine, David Cutler of Harvard University and Wendy Everett of the New England Healthcare Institute offer their ideas on improving adherence to medication regimens.

They recommend lowering patient's co-payments for medications to remove financial barriers, expanded use of health information technology to track medication histories and whether prescriptions are filled or refilled, payment reform that rewards providers for better outcomes, and improved screening of patients who might be at risk for poor adherence by virtue of depression, for example. The moment is ripe for change, they say, as the federal health care law moves closer to implementation.

"The bottom line is this: We've known for some time that improved adherence can lead to improvements in health outcomes and reductions in health care spending. What we haven't known is where to start," they write. "Now we just need to get moving."