Chronic diseases such as cardiovascular disease and diabetes are among the leading cause of death and disability in the United States, greatly affecting patient quality of life and health care costs. Polypharmacy or taking too many medications presents one sort of problem that can affect Wellness. Another, is not taking or improperly taking prescribed medications.
In response to the growing epidemic of chronic diseases, workplace wellness programs have increased in popularity. This popularity was assisted by the advent of the Patient Protection and Affordable Care Act to provide health promotion and disease management programs proven to reduce health care costs. Currently, workplace wellness programs have expanded to a $6 billion dollar industry in the United States.
Nonadherence to taking prescribed medications to help control chronic diseases and improve function is adversely affecting job performance. This problem is leading to unnecessary complications, disability, and in too many cases, premature death. Complicating the gravity of this matter is the fact that chronic diseases once thought to be a public health problem associated mainly with older age groups, have shifted to the younger working-age population. This shift to a younger age group creates an increased economic burden resulting from illness-related loss of productivity due to absence from work (absenteeism) and reduced performance while at work (presenteeism). On top of this issue is the phenomenon of delayed retirement. An increasingly older population of adults are now remaining in the workforce.
So let’s look at some sobering stats. As of 2012, approximately half (117 million) of U.S. adults had one or more chronic diseases. A study by the Milken Institute calculated that seven chronic conditions (cancer, heart disease, hypertension, mental disorders, diabetes, pulmonary conditions, and stroke) are costing the U.S. economy $1 trillion per year. Anticipated growth rates for the aforementioned conditions are expected to yield an illness burden of $4 trillion per year by 2023. The American Heart Association estimated total costs associated with heart disease and stroke diagnoses in 2010 to be $315.4 billion. The total estimated cost associated with diabetes diagnoses in 2012 was $245 billion, including $176 billion in direct medical costs and $69 billion in decreased productivity (eg, absenteeism, presenteeism).
One statistic that should receive more attention deals with medication nonadherence. Approximately 20% to 50% of patients inadequately adhere to taking prescribed medications. This issue has been estimated to contribute to $290 billion in unnecessary health care costs. Unfortunately, there is no single intervention strategy that has been shown to be effective across all patients, conditions, and settings.
As chronic disease prevalence continues to increase, it is important to note that these diseases are often preventable and can be managed by:
The first 5 of these management strategies are typically focused upon in most wellness and safety programs. However, it is #6, medication adherence, that may be too often overlooked. Workplace wellness programs need be designed to target medication nonadherence via disease management programs. Educating employees about the importance of adhering to proper medication, avoiding excessive polypharmacy, and being followed up properly by qualified healthcare providers are critical components of a worker wellness program.