Medication is a relatively inexpensive and efficient therapeutic strategy for treating a number of illnesses. However, the average rate of compliance for patients on chronic therapies is about 50% after one year and declines over time. Approximately 10% of hospital admissions are related to medication issues, and 23% of nursing home admissions are related to medication problems. Medication noncompliance is estimated to cost the US healthcare system an estimated $76.6 billion a year. The elderly represent an important population among those receiving drug therapy. They receive 30% of all prescriptions and buy 40% of all over-the-counter drugs. In 2003, there were an estimated 36 million people age 65 or older in the United States, accounting for almost 13% of the total population. The inability to manage medications is one of the leading reasons why seniors need additional, often more expensive care. Understanding the causes of noncompliance and identifying methods to help patients follow their regimens may improve health outcomes and reduce related costs. Such a methodology would facilitate aging in place and may delay the need for admission to assisted living facilities. The health decision model suggests that noncompliant behavior is multi-factorial. By modifying general and specific health beliefs, enhancing social interaction factors, and optimizing administration, compliance can be improved. In Phase II, we propose to determine whether the eMedonline medication management system improves compliance among elderly patients being treated for hypertension. We will evaluate effects on medication compliance, perceived social support, and feelings of control over health destiny in a sample of patients. We will also evaluate the acceptability of the system in a sample of healthcare providers, pharmacists, and caregivers.
