(photo credit: INGIMAGE / ASAP)
Interventions to increase public compliance in taking their prescription medications as set down by their doctors will in a few weeks be established by the Health Ministry’s pharmaceutical division, The Jerusalem Post learned on Monday.
Although the ministry does not have accurate figures on the phenomenon here, division head Dr. Eyal Schwartzberg believes they are similar to those in most developed countries around the world, causing a loss of tens of millions of shekels annually and endangering the health of chronically ill patients. In the US alone, failure to comply in taking prescribed drugs cost $320 billion a year.
Just two weeks ago, a systematic review on the cost of patients not taking their medications as prescribed was published in The Cochrane Library, the UK-based collection of databases containing different types of high-quality, independent evidence to promote informed decision-making. In a review of 182 different clinical trials since 2007, it found that only half of patients take their medications as prescribed. Many patients stop purchasing or taking prescribed medication altogether, while others do not follow the instructions for taking it properly.
Schwartzberg announced another innovation, in which pharmacists in chain and private pharmacies will be invited to set up “consultation rooms” on the premises to test customers for their blood pressure, weight, height, level of HbA1c (a measure, with a simple blood test, of blood sugar over three months) in non-diabetics and check for diabetic-foot sores. Pharmacies already sell some of the devices needed for these tests.
While the pharmacists may charge for this service, the ministry’s chief pharmacist said there is no need for this, as it would surely bring in customers. The consultation rooms will become mandatory at new pharmacies and optional at existing ones, he said.
After this, Schwartzberg hopes that pharmacists may undergo a 50-hour training course at medical schools for administering flu shots, for which they may charge as well; at present, there are long queues at the autumn/winter influenza season, for free shots at health fund clinics. Pharmacists would also need insurance coverage if they provide this “invasive” service, he said.
As for compliance in taking prescription medications, Schwartzberg said that a number of “stakeholders” -- including the pharmaceutical companies, public heath funds and the chronically ill would be involved. The proposed instructions have been sent to senior ministry officials, the Israel Manufacturers Association, district pharmacists, representatives of the pharma industry and patients’ groups for comments before the program is launched in a matter of weeks.
“The lack of health literacy in numerous sectors in the population has a major share in the failure of many patients’ not following through and taking their drugs,” he said. “Another is that the poor cannot afford the copayments for drugs, so they purchase only some of those they are prescribed by doctors. “We must raise public awareness that when they are prescribed medications for heart disease, hypertension, diabetes and other conditions, it is very important to take them as instructed to prevent a decline in their health,” said Schwartzberg.
Privacy of patients will absolutely be protected when they seek “objective, not commercial or advertising information” from the drug companies, patients’ groups and other sources. Pharmaceutical firms will not be able to praise their products or bad-mouth their competitors, and the entire process will be supervised to prevent abuse, he said. All written materials will have to be approved by the ministry before they may be published.
Patients going into websites about specific conditions will have to enter a code to enter, said Schwartzberg, and information about them may not be stored by the companies. As for people who do not have Internet access or are unable to understand such sites, phone lines will be made available. Objective booklets on diseases and medications will also be distributed, and video will be provided to explain how to properly take medications.
Schwartzberg said that while countries around the world are looking for ways to boost compliance in taking prescribed drugs, “we are the first who will do this nationally through regulation.”