Pandemics and Your Medication Adherence

If you suffer from asthma or chronic obstructive pulmonary disease, better known as COPD, why would you not take your medication as prescribed? You take it, you can breathe, you stay alive. You don’t take it, you may not be able to breath, you may die.

All things being equal (you can afford your medication, you have access to your medication, there’s no shortage of your medication, there’s no new side effect preventing you from taking it, etc.), you should take your medication, right? It’s only common sense.

But this is America, dammit. No one is going to tell you what to do, even if it’s going to keep you alive, and even if it’s going to keep you alive during a deadly pandemic like the one we’re experiencing now that’s killing tens of thousands of people across the country.

A new study published this month in the Journal of Allergy and Clinical Immunology: In Practice offers an interesting glimpse into the medication adherence minds of Americans with chronic illnesses.

Researchers from Propeller Health and ResMed looked at the changes in the medication adherence of patients suffering from asthma or COPD. Propeller Health is a Madison, Wis.-based company that makes a device that monitors patients’ use of inhalers. ResMed, a San Diego-based medical device company, owns Propeller Health. All of the researchers are employees of either Propeller Health or ResMed. 

Seventy-seven percent of the 7,578 patients in the study took daily medication to control their asthma, while 23 percent took daily medication to control their COPD. The patients’ median age was 40, and 67 percent were female.  

The researchers compared the percentage of patients who took their daily medications as prescribed Jan. 1-7 with the percentage who took them as prescribed March 25-31. A little thing called COVID-19 happened in between, and the virus is especially dangerous for patients with respiratory illnesses like asthma and COPD.

What you thought might happen did happen.  The percentage of patients who were adherent to their daily controller prescriptions for asthma or COPD rose to 61.5 percent during the last week of March compared with 53.7 percent during the first week of January. The fear of COVID-19 wreaking havoc on their already fragile respiratory system made more people take their prescribed medications.

“The trend may be reflective of patients responding to national COVID-19 guidelines and to patient concern about controlling their primary respiratory illness with their controller medications,” the researchers said.

Here’s what’s interesting to me. The increase was only 7.8 percentage points, or not even 15 percent, if you do the math. The fear of COVID-19 stealing whatever breaths they had left scared fewer than 600 more people into taking the drugs that they need to help them breathe. And, even after the increase, nearly 40 percent of all the people in the study still didn’t take their drugs as prescribed. 

I mean, if the threat of contracting a deadly virus that destroys your respiratory system when you don’t have much of a respiratory system anyway doesn’t drive drug adherence substantially higher, what will? That’s how big a challenge medication adherence is, especially for patients with chronic illnesses.

It’s why we need effective, market-based solutions to incent people to take their drugs as prescribed. We’re Americans. We may not respond to existential threats. But we do respond to money. 

Thanks for reading.

Stay home, stay safe, stay alive. And take your pills.