Hospital and Physician Update

September – October 2019

Guest column from Kenneth L. Salzman, Ph.D., licensed psychologist
What role can behavioral health play in improving medication compliance?

Kenneth L. Salzman is a licensed psychologist in independent private practice in Lansing. He’s been practicing for 46 years and currently serves on the Insurance Committee of the Michigan Psychological Association. He’s also worked with Blue Cross Blue Shield of Michigan on the “Integrating Behavioral Health into General Medical Care” initiative, part of the Physician Group Incentive Program.

Patients receiving medications often grapple with one or more of the following issues:

• They might not like the idea that they need to take medication at all, perhaps because they’re not sure they actually need it or they simply don’t like taking medication.
• They might find that the medication is a cost burden that creates additional stress for them.
• The medication may not seem to be working.
• The medication may present undesirable side effects. If they take multiple medications, they may experience unintended interaction effects.
• They might be experiencing other life issues that get in the way of them taking their medication.

Any of these issues — or a combination — can result in medications not being used as prescribed. Noncompliance is, in essence, a behavioral issue, and behavioral health specialists are uniquely skilled in working with such issues.

About behavioral health specialists
Behavioral health specialists include licensed clinical psychologists, licensed master clinical social workers and limited licensed clinical psychologists, among other provider types. A session with a behavioral health specialist usually lasts 45 minutes to an hour, and sessions are generally conducted weekly. This gives specialists ample time to explore possible problems and allows them to provide frequent updates on the patient’s progress to his or her medical doctor.

How a behavioral health specialist can help
While the patient may not immediately volunteer information about medication compliance issues, the behavioral health specialist can ask directly if they’ve been prescribed any medication and if they’re taking it as prescribed. The behavioral specialist is skilled at addressing sensitive issues with necessary care and assisting the patient in coming to terms with the many factors that motivate their behaviors.

The behavioral specialist facilitates the patient’s ability to resolve conflicts and establish more effective behavioral patterns. This includes achieving better medication compliance and improved communications with their prescribing physicians regarding any issues they may be having with the medications.

Additionally, when prescribing physicians and behavioral health specialists communicate regularly about their shared population of patients, the efficacy of medication regimens increases significantly.

In my next column in this newsletter, I’ll be looking how psychotherapy can be used in combination with medications to reduce the symptoms of bipolar disorder.

Did you know?
According to the U.S. Health Resources and Services Administration, not taking medication as prescribed results in:

• 10% of total hospital admissions
• 22% of nursing home admissions

Not taking medication as prescribed also is associated with 125,000 deaths. This results in $100 billion a year in unnecessary hospital charges and costs the U.S. economy $300 billion a year.

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