“Adherence to medications is a significant challenge in chronic disease management,” explains a research article on Understanding Treatment Adherence in Chronic Diseases.

Furthermore, “Medical adherence is a complex issue, influenced by multiple factors, including patient-related, medication-related, and healthcare system-related barriers.” The study adds that “poor adherence can lead to adverse patient outcomes including disease progression, increased morbidity, reduced quality of life, higher hospitalization rates, increased medical costs, and mortality.”

Providers can use HIPAA compliant emails to help patients understand their treatment and address concerns to improve patients’ medication adherence.

 

Why patients struggle with chronic medication adherence

Medication non-adherence can generally be divided into two categories:

Intentional non-adherence

Intentional non-adherence occurs when patients consciously decide to alter or stop their treatment. They may believe their condition is under control or question whether the medication is necessary.

 

Unintentional non-adherence

Unintentional non-adherence occurs when patients want to follow their treatment plan but encounter barriers that make doing so difficult. For example, when a patient forgets doses, struggles with complex schedules, runs out of medication, or faces financial and logistical obstacles.

 

Patients underestimate the consequences

Patients may intentionally stop taking medication when they do not feel sick. The researchers explain that “patients may believe their condition is under control, either due to effective treatment or a lack of symptoms.”

For example, a patient with high blood pressure (hypertension) may feel well while taking medication or after their blood pressure improves, leading them to believe continued treatment is unnecessary. However, untreated or poorly controlled hypertension can contribute to serious complications like heart attack or stroke.

When treatment successfully controls symptoms, patients may interpret improvement as evidence that they no longer need the medication.

Healthcare providers can use HIPAA compliant emails to send an educational message explaining why patients must continue their treatment even when symptoms have improved. The message could also provide instructions for what to do if they have questions about continuing their medication.

 

Inadequate education can affect adherence

The review identifies inadequate disease awareness and education as important contributors to intentional non-adherence. Patients may not understand what could happen if their condition progresses or why a medication needs to be taken consistently. This can happen when a patient forgets the information provided during their appointment or when they are dealing with a new diagnosis.

Providers can use HIPAA compliant emails to help solve this problem, sending patients a summary of why the medication was prescribed, how and when it should be taken, what patients should do if they miss a dose, when to contact the healthcare team, and when the medication should be refilled.

Patients can then review this information directly in their inbox rather than relying entirely on their memory of the appointment.

 

Poor communication can undermine adherence

According to the article on Understanding Treatment Adherence in Chronic Diseases, “Low engagement from [providers] can contribute to patients feeling underinformed and lead to inconsistent follow-up.”

As a result, patients who do not understand why a medication is necessary may be less likely to continue taking it. Similarly, patients experiencing side effects may stop treatment without consulting their healthcare provider if they can’t easily ask their provider follow-up questions.

The article cites research showing that 21% of patients recently discharged from hospital found it difficult to understand why their medications had been prescribed, while 68% said that a follow-up call could have improved adherence.

HIPAA compliant emails are the easiest way for healthcare providers to check whether patients understand their medication instructions or provide follow-up information if they encounter problems. These secure emails can also help providers identify potential adherence barriers earlier, like patients not being able to afford their medications.

 

Barriers that affect adherence

The review identifies financial constraints, limited healthcare access, transportation problems, and geographical barriers as contributors to unintentional non-adherence. Patients may delay treatment, reduce doses, or avoid filling prescriptions because of cost.

Transportation can create another obstacle. The review describes research in which patients discharged from hospital experienced delays in filling prescriptions, while 65% identified transportation assistance to the pharmacy as something that could improve adherence.

Providers can use HIPAA compliant emails to identify these barriers. For example, secure email could be used to ask patients whether they are experiencing difficulty obtaining a prescription and direct them toward available financial assistance, pharmacy services, medication support programs, or appropriate members of the care team.

 

Side effects can lead patients to stop treatment

“Fear of experiencing side effects is a common reason for non-adherence across multiple medications and conditions,” the study explains. These side effects can “cause a range of unpleasant side effects ranging from gastrointestinal issues such as nausea, diarrhea or constipation, neurological issues such as headache and changes in mood, or physical discomfort in the form of weight gain, cough, dry mouth, and skin irritation.”

These effects may lead to patients reducing their dosage, skipping doses, or stopping treatment altogether. Some may also rely on “self-medication,” where they adjust the dose or frequency without consulting a healthcare provider.

HIPAA compliant emails can encourage patients to report unexpected or persistent side effects. Providers can then use their response to determine whether they need additional education, monitoring, a medication adjustment, or an appointment.

 

Complex medication schedules can affect adherence

Complex treatment regimens can require patients to remember different doses, timing requirements, food restrictions, and medication interactions. The review notes that “adherence decreases as the number of daily doses increases.”

In such cases, a secure email could, for example, provide a written summary after a medication review, so patients have a reference point when managing several prescriptions. For example, if a patient has lupus and is prescribed corticosteroids (e.g., cortisone) and methotrexate, providers can securely send them a tapered dosing schedule to help them keep track of when and how much of each medication to take. This can help reduce confusion and improve adherence to the complex treatment regimen.

 

Forgetfulness and unintentional non-adherence

Forgetfulness is one of the most common reasons patients unintentionally miss medication doses. The above-mentioned research article references a large survey on unintentional non-adherence to chronic prescription medications, in which up to 62% of patients reported forgetting to take their medication.

Furthermore, the review identifies depression, cognitive impairment, and “brain fog” as factors that can negatively affect adherence. For patients managing busy work schedules, family responsibilities, appointments, and multiple medications, remembering every dose can be difficult.

Secure email can complement medication reminder systems where healthcare teams could send reminders about prescription refills, follow-up appointments, medication reviews, or other aspects of treatment management.

The review specifically identifies mobile medication reminders and disease-related applications as technology-based interventions that can help patients manage their medication regimens. HIPAA compliant email solutions, like Paubox, can help patients manage their medication schedules, supporting the technology-based interventions suggested here.

 

Improving patient engagement

Medication adherence often depends on sustained engagement, as evidenced in the first research article, “Strengthening [provider]–patient communication is therefore key.”

Paubox email is proven to improve patient engagement, leading to better health outcomes. For example, providers can use secure email to send medication instructions, share personalized treatment information, follow up after a new prescription, provide disease education, and encourage patients to report medication-related concerns.

 

Secure email can support shared decision-making

The review explains that “shared decision-making involves patients being actively involved in discussions about their treatment decisions,” which can make it more likely that patients receive a regimen they can realistically manage.

For example, after discussing several treatment options, a provider could securely send the patient information about the agreed options and instructions for follow-up. The patient can then review the information and raise concerns that may not have occurred to them during the consultation.

 

HIPAA compliant email should complement care

The review emphasizes that “No single approach fits all.” Improving adherence therefore requires patient-specific interventions that may involve physicians, nurses, pharmacists, caregivers, patient support programs, and other members of the healthcare team.

Patients may still face financial difficulties, transportation barriers, side effects, complex treatment regimens, or difficulties accessing healthcare. Some patients may also have limited digital literacy or access to technology. In these cases, HIPAA compliant email is a solution that should form part of holistic patient care.

As the review concludes, effective adherence management requires “open patient–HCP discussions to identify adherence barriers, personalized treatment, and addressing unintentional disruptions.”

Ultimately, HIPAA compliant emails can help facilitate those discussions, allowing education, follow-up, and treatment-related questions that further patient engagement.

 

FAQs

Do HIPAA compliant emails improve patient care?

Yes, HIPAA compliant emails improve the accuracy, security, and reliability of patient communication, helping providers deliver better and safer patient care.

 

What makes an email service HIPAA compliant?

Providers must use a HIPAA compliant email service with encryption, access controls, audit trails, and secure data storage. Additionally, the email service should sign a business associate agreement (BAA) to adhere to HIPAA regulations regarding the security and privacy of protected health information.

 

Can providers discuss patient information over email with other healthcare providers?

Yes, providers can use HIPAA compliant emails to discuss patient information as long as it is necessary for treatment, payment, or healthcare operations and appropriate security measures are in place.

Read also: Using HIPAA compliant emails to improve provider collaboration