COVID-19 and Mental Health – Medication Adherence Can Reduce Negative Effects

May 29, 2020 HMS

May is Mental Health Month. This year, the national initiative to increase awareness about mental health issues coincides with the COVID-19 pandemic. An increased focus on mental wellbeing is more important than ever these days, since researchers from various organizations have found that the coronavirus is negatively affecting Americans’ mental health:

  • The U.S. Census Bureau’s Household Pulse Survey has found that close to one third of Americans are exhibiting signs of clinical anxiety or depression.
  • The Kaiser Family Foundation released poll results in April that revealed that close to half of Americans feel that COVID-19-related stress is having a negative effect on their mental health.
  • The American Foundation for Suicide Prevention conducted a survey which found that people in the United States are more anxious and more sad than prior to the pandemic.

Health plans must pay particular attention to these findings for two reasons. First, it’s essential that existing behavioral health patients continue to manage their conditions during these challenging times. Second, the stress associated with COVID-19 is increasing the risk of mental health issues among members who formerly had no behavioral health needs.

For both groups of individuals, a commitment to medication adherence is key to treating behavioral health conditions. People either stop taking their prescriptions or take them inconsistently for a variety of reasons. For example:

  • The belief that the medication is no longer necessary if symptoms go away after the initial doses
  • Fear of real or perceived side effects
  • Inability to access medications, due to affordability or other factors
  • Confusion about how and when to take prescriptions, due to cognitive issues or instructions that simply aren’t clear

Today, deploying medication adherence improvement programs may be more important than ever for health plans. The human cost of mental health issues continues to grow as the COVID-19 pandemic persists. Medication adherence can address that issue and it can also reduce the rising clinical risks associated with individuals who stop taking their prescriptions. Developing a medication adherence program requires three actions:

  1. Identifying which members aren’t taking their medications as directed. Without this critical first step, it’s impossible to intervene in targeted ways to improve medication adherence. HMS’ Elli, a risk intelligence solution, analyzes members’ prescription refill rates. Based on this information, Elli’s Medication Possession Ratio shows care managers which members are taking their prescriptions consistently. This targeted, member-level information forms the foundation of a robust medication adherence outreach program.
  2. Conducting outreach to identify the members’ point of view about their medications. Health engagement solutions, such as HMS’ Eliza, are a great way to contact individuals who aren’t taking their prescriptions for mental health conditions. HMS recently worked with a client to address antidepressant medication adherence among its Medicaid population. The goals of the outreach program were to identify barriers to medication adherence and to remind members to refill their prescriptions. Members in the target group received an IVR call with the option to transfer to behavioral health counselors. This program found that forgetfulness was a key barrier to medication adherence among this population. Another HMS client used Eliza to conduct a medication adherence campaign and saw a 40% increase in member refill rates in the targeted population.
  3. Creating engagement programs that are tailored to different treatment phases. Given the increased stress associated with COVID-19, health plans are more likely to see people begin treatment for mental health issues. To promote medication adherence among this group, health plans may want to launch an outreach campaign specifically for these members when they first fill a prescription. This may include education about the importance of medication for their condition, as well as information that identifies and addresses barriers to care. Tailored outreach is also important for members who began treatment for behavioral health issues before the outbreak of COVID-19. For those who have moderate adherence challenges, “low touch” communication like regular refill reminders and tools to encourage healthy behaviors may be enough to keep them on track. For members who have more serious adherence problems, health plans may need to deploy more intensive outreach and interventions. Beyond medication adherence, outreach can also help people manage their mental health conditions more effectively. We’ve found that members who engage with their health plan through an outreach program are 72% less likely to readmit after a behavioral health event. Health engagement solutions that support a variety of outreach channels, including phone, text, email and real-time transfer to a health coach are essential.

The uncertainties associated with COVID-19 are unlikely to go away in the near future. As people grapple with this new reality, many will need help to address existing or new mental health issues. Fortunately, treatments are available. They only work, however, if people adhere to them. Real-time population health analytics, coupled with thoughtful, personalized outreach from health plans can help members cope during this difficult time.

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