Exploring Mental Health Treatment, Adherence Challenges, Solutions

June 26, 2023 - In this episode of Healthcare Strategies, Colin Banas, MD, MSHA, Chief Medical Officer at DrFirst, discusses the importance of mental health treatment and the main challenges for medication adherence and management. The conversation shed light on various aspects of improving medication adherence and mental health outcomes, as well as the role of technology in addressing these challenges. 

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Banas highlighted three main challenges contributing to medication non-adherence: cost, lack of patient education, and forgetfulness.  

"Cost is a big challenge — once that copay gets into the $50–100 range, medication adherence plummets," mentioned Banas. A study published in JAMA Network Open found that high prescription drug costs have caused older patients over 65 to ration medications, limiting treatment adherence.  

Additionally, a lack of patient education also plays a role, as patients may not fully understand the purpose and importance of their medication or potential side effects. Forgetfulness can also hinder adherence, with patients sometimes failing to pick up or refill their prescriptions. 

"A quarter of [America’s] prescriptions go unfilled," revealed Banas, citing an article published in the Journal of General Internal Medicine. "Life gets in the way, and forgetfulness leads to abandoned prescriptions." 

To improve medication adherence and mental health outcomes, Banas emphasized the need for collaboration between healthcare providers, patients, and their families. Engaging the patient's support system can help address the challenges of mental illness and improve treatment adherence.  

With the advancement of technology, various digital tools can facilitate this collaboration. Patient portals, text messages, and chatbots offer opportunities to communicate, educate, and support patients. 

Banas explained how medication adherence can be monitored using tools such as medication dispense history and real-time data analysis. By accessing pharmacy data, healthcare providers can track patients' prescription fills and identify potential adherence issues. These tools enable clinicians to proactively intervene when adherence rates fall below optimal levels. 

Addressing privacy concerns, Banas assured that patient consent is obtained when accessing medication data. Patients can opt out and control the sharing of their information. Respecting patient privacy is a priority, and the data collection process adheres to ethical guidelines. 

Managing patients who refuse to take their medications due to side effects or other concerns related to mental health conditions was discussed as a complex challenge. Banas emphasized the importance of understanding the reasons behind patients' refusal and engaging in meaningful conversations to explore alternative options.  

“Whether it’s a spouse or other family member, mental illness is hard. Luckily, [drug development] is at an age where there are alternatives. For every medication that has a side effect, there is usually a therapeutic equivalent that doesn't or has a different effect profile."  

By exploring therapeutic equivalents, long-acting treatments, and upcoming developments in the field, healthcare providers can offer potential solutions to improve adherence. 

Looking to the future, Banas expressed optimism about the advancements in mental health and medication adherence. The pandemic has shed light on the importance of mental health, reducing stigma, and increasing awareness.  

"We're at an important inflection point in healthcare delivery, particularly with the intersection of technology,” Banas said. With that, there is great potential for further innovation.  

The combination of technology, collaboration, and personalized patient engagement holds promise in overcoming the challenges of medication adherence and improving mental health outcomes, he concluded.