Can Pharmacogenetics Increase Adherence?
Failing to follow directions can be deadly. The New England Healthcare Institute (NEHI) estimates that one-third to one-half of American patients do not take their medications as prescribed and that drug-related morbidity, including adherence problems, results in as much as $290 billion in extra medical costs each year.
There are many reasons for this nonadherence. Some patients struggle to remember exact instructions, schedules or have trouble paying for the medications. New programs and applications such as DrFirst and SimpleMed+ can help address cost and memory issues, but research now suggests that trust and communication play a large role in adherence as well.
It makes sense that patients would be less likely to admit to nonadherence when they’re afraid of criticism or admonishment. But the nonadherence itself often stems from poor communication too. In The Challenge of Patient Adherence, the authors say the patient must believe the physician is someone who understands their unique story and characteristics and actively involves them in care choices.
Sounds a bit like personalized medicine.
Pharmacogenetic testing can help prescribers hone in on effective medications without resorting to trial and error prescribing, which can frustrate and discourage patients. Plus, pharmacogenetic testing can prevent side effects and simplify complicated drug regimens, which can also help improve adherence.
Favorable Behavorial Effects
But it turns out there may be psychological effects as well. Studies have also shown patients were more adherent after genetic testing, no matter what their test results indicated. Just the fact that the doctors took the extra step improved the patient’s adherence to their prescription, even if the medication regimen didn’t change. “A pharmacogenetic test result communicated directly to patients has a favorable effect on their health behavior,” said Charland et al. (2013), “…Patients have some degree of personal utility for the information provided.” Perhaps pharmacogenetic testing can help patients feel like the doctor understands their unique situation, feel like they’re more of an active participant in their healthcare decisions and reinforce their trust that chosen medications are worth taking.
Pharmacogenetics: Part of the Solution
Medication nonadherence is a major problem in the American healthcare system today and no single solution will completely solve the pharmaceutical or psychological causes of it. But by using pharmacogenetic testing, prescribers can not only improve adherence, medication efficacy and avoid adverse events, but also build a stronger, more trusting relationship with their patient.