COVID-19 has disrupted many of the daily routines we take for granted, in the healthcare sphere and beyond. One of those routines is as simple as taking medication for conditions on time and as directed.
Studies have consistently shown that 20% to 30% of medication prescriptions are never filled and about 50% of medications for chronic disease are not taken as directed. That lack of adherence costs the healthcare system at least $100 billion each year.
But thanks to COVID-19 and its effects on factors as basic as the supply chain, access to essential medications, and the availability of therapeutic resources, medication adherence has been even more seriously impacted.
The global medication supply chain has undergone serious challenges since COVID-19. Many of the active ingredients for medications dispensed in America are sourced and created in factories overseas, including in China.
In an NPR article on how coronavirus is affecting the U.S. pharmaceutical supply, it was noted that several U.S. drugmakers, including Pfizer and Mylan, “told their investors that the virus could harm their ability to manufacture products or get supplies to do so.”
Travel and trade restrictions on international goods, including Chinese goods, have created a global scarcity for many drugs on which people rely daily. Shortages are not at crisis levels but there is a notable disruption in supply, with many industry analysts warning of a second wave of disruption.
Many medical practices, including those in underserved and rural communities, have undergone temporary shuttering as a result of COVID-19. Lockdowns and restrictions on patient movement are some of the major tools of public health in this time.
Patients have been urged to stay at home and avoid dangerous places where the sick gather, such as a doctor’s office. This means that many offices, faced with a lack of patients, have either closed down or switched to telehealth practices.
Unfortunately, there are many patients who are uncertain how to navigate these new or lessened resources in order to get their medications prescribed, filled and refilled. Depending on the condition, a lapse of even one day in medication adherence can have dire consequences.
There is one specific and vulnerable population that relies on provider-client trust in order to maintain adherence: populations with mental health disorders. Medication adherence is closely tied to in-person provider interactions in this population, which needs constant reminders to take their medication.
With communication between provider and client eroded thanks to COVID-19 strategies such as closing clinics or switching to telehealth services, this vulnerable population is even more vulnerable to a lapse in medication adherence. The lack of communication quickly leads to a lack of trust and dialogue, which can be a major factor in maintaining adherence.
On top of that, the daily stress and fear caused by the pandemic affects both disease outcomes and medication adherence. Patients who are anxious and stressed may feel hopeless when it comes to improving their health outcomes, leading to a lack of adherence and perhaps even the erosion of health gains prior to the pandemic.
One way to support medication adherence is through the use of technology, like mobile text messaging, to remind the patient to take their medication.
In a 2018 systematic review of medication adherence for patients suffering from mood disorders, “results showed overall satisfaction and feasibility of mobile technology, and reduction in mood symptoms.” The study concluded, “Mobile technologies have the potential to improve medication adherence and can be further utilized for symptom tracking, side effects tracking, direct links to prescription refills, and provide patients with greater ownership over their treatment progress.”
With the Medly Pharmacy app, available on iOS, patients will be able to take that ownership over their treatment by ordering refills, signing up for home delivery of medications, and more.
No matter what further effects the COVID-19 crisis has on healthcare systems, providers need to be vigilant in monitoring how changes in access impact the utilization of health care resources, medication adherence, and use patterns with both populations and individual patients.