Taking Our Medicine - Improving Adherence in the Accountability Era

Many U.S. patients do not adhere to prescribed medication regimens, ultimately costing the United States $100 billion to $290 billion annually. As physician payment is increasingly tied to patient outcomes, nonadherence poses new challenges and opportunities. A new patient with an abnormal electrocardiogram comes to your office. He is 53, smokes, and has hypertension and hyperlipidemia. Though he comes for preoperative risk evaluation, he needs more than medical clearance he needs a primary doctor. Given his risk factors and hesitance to change his lifestyle, you recommend aspirin, a statin, and an antihypertensive. When he doesn't show up for his stress test, you call him, and he says he doesn't understand what the fuss is all about he feels fine. Why don't you wait until something is wrong with me to give me these medications? ...