Medication Non-Adherence

Increases Hospitalization 17% and All-Cause Mortality 27%

July 2026

Multiple studies continuously report the results of medication non-adherence for specific diseases. However, many elderly patients have multiple morbidities, suggesting that an all-cause approach would also be valuable. Thusly, Caroline Walsh of the Royal College of Surgeons in Ireland published a study taking this approach.¹ Walsh and colleagues performed a systematic review and meta-analysis of 66 studies. They concluded that medication non-adherence across all diseases did not impact quality of life or emergency department visits. On the other hand, medication non-adherence increased all-cause hospitalization by 17% and all-cause, long-term mortality by 27%.

How common is this problem?

The answer ranges widely across several variables. Studies have found 80% of patients adherent to endocrine therapy,² 47% of patients adherent to osteoporosis treatment,³ and only 8% of ACEI/ARBs users to be adherent in one hemodialysis-related study.⁴ This is further influenced by patient-related variables. In an overview of systematic reviews, Alina Gast and Tim Mathes synthesized 21 systematic reviews and concluded that medication adherence increases with higher financial status and socioeconomic position, decreases with patients age 70+, decreases with co-payments, and decreases with depression.⁵    

Does home health improve medication adherence?

We were unable to find a peer-reviewed study that answers the question. Medicare provides important evidence, though. Medicare tracks several measures of patient health at admission and discharge for all home health patients. This includes questions about a patient’s ability to independently adhere to an oral medication regimen. Among patients demonstrating non-adherence, on average, home health improves medication adherence in 65% of cases.⁶  

The nurses of Ideal Home Care have ways of verifying each patient’s ability to manage medications independently. They can examine your patient’s medicine cabinets, med minders, and kitchen cabinets to see what medicines and dietary supplements your patient uses. Nurses have your patient explain the purpose and schedule of each medication. Our nurses use teaching sheets for many types of medications. They will teach and follow-up on later visits to verify retention of the information and adherence. Ideal Home Care nurses can recruit friends and family as necessary to help with medication reminders. They can also use the home environment to set up enhanced reminder systems. Nurses can make multiple home visits as long as patients make learning progress. We will report to the physician if your patient is unable to demonstrate understanding and compliance. Similarly, our nurses can help with teaching of and adherence to therapeutic diets. 

Which patients are eligible for home health medication teaching?

Any time there is a new diagnosis, a change in medication, or suspected non-adherence, homebound patients will meet Medicare’s skilled need criterion. 

Medicare Pays 100%

When your patients are homebound and could benefit from an episode of nursing or physical therapy, traditional Medicare pays 100% of charges from Ideal Home Care. Your patients have no copay, no deductible, and no cost sharing of any kind. Refer to Ideal Home Care to ensure optimal outcomes, save money for patients, and lower overall healthcare spending.  

Please offer Ideal Home Care to Your Patients.

References

1. Walsh CA, Cahir C, Tecklenborg S, Byrne C, Culbertson MA, Bennett KE. The association between medication non‐adherence and adverse health outcomes in ageing populations: A systematic review and meta‐analysis. British Journal of Clinical Pharmacology. 2019 Nov;85(11):2464-78.
2. Hsieh KP, Chen LC, Cheung KL, Chang CS, Yang YH. Interruption and non-adherence to long-term adjuvant hormone therapy is associated with adverse survival outcome of breast cancer women-an Asian population-based study. PloS One. 2014 Feb 21;9(2):e87027.
3. Lakatos P, Takács I, Marton I, Tóth E, Zoltan C, Lang Z, Psachoulia E, Intorcia M. A retrospective longitudinal database study of persistence and compliance with treatment of osteoporosis in Hungary. Calcified Tissue International. 2016 Mar 1;98(3):215-25.
4. Liao KM, Cheng HT, Lee YH, Chen CY. The effectiveness and safety of angiotensin-converting enzyme inhibition or receptor blockade in vascular diseases in patients with hemodialysis. Medicine. 2017 Mar;96(13).
5. Gast A, Mathes T. Medication adherence influencing factors—an (updated) overview of systematic reviews. Systematic Reviews. 2019 Dec;8(1):1-7.
6. Levit A, Galantowicz S, Fout B. Modifications to the Quality of Patient Care Star Rating Algorithm for Home Health Agencies. CMS: Medicare Learning Network. 2018.
7. Xiao R, Miller J, Zafirau W, et al. Impact of home health care on health care resource utilization following hospital discharge: a cohort study. The American Journal of Medicine. 2018; 131 (4): 395-407.