Magazine article Drug Topics

Multifaceted Strategies Can Improve Patients' Medication Adherence

Magazine article Drug Topics

Multifaceted Strategies Can Improve Patients' Medication Adherence

Article excerpt

Interventions for medication adherence should be multifaceted, speakers told attendees at the recent Pharmacy and Technology Conference in San Diego sponsored by the National Association of Chain Drug Stores.

Different patients have different reasons for poor adherence, and simple interventions usually address only one reason for poor adherence, said David Nau, PhD, RPh, CPHQ, senior director for research and performance measurement, Pharmacy Quality Alliance, and Rick Mohall, PharmD, director of field clinical services, Rite Aid.

In the United States alone, the cost of medication nonadherence is more than $ 1 70 billion annually. According to the New England Healthcare Institute (NEHI), 13% of total healthcare expenditures may be due to poor medication adherence, and nearly $300 billion is wasted because patients don't take their medications.

"A multifaceted intervention may require collaboration of drug plans and community pharmacies," said Nau.

This type of intervention might:

* Minimize cost share for patients with high-risk conditions such as diabetes

* Identify patients' concerns about medications they are taking (e.g., side effects, dependence) and provide personalized counseling addressing these issues

* Simplify the drug regimen

Patients with diabetes, chronic obstructive pulmonary disease, asthma, or heart failure, and patients who were recently discharged from the hospital after admission for any cardiovascular condition are prime candidates for interventions. "The return on investment for these patients should be excellent," Nau said.

Reducing refill complexity

There is increasing evidence that reduced complexity can greatly affect whether patients obtain timely refills, Nau said. "One type of complexity occurs if the patient has multiple chronic medications but is getting them refilled on different dates and perhaps at different pharmacies," he said.

Some small studies have shown that a significant improvement in adherence can occur if the refill dates are consolidated, so that patients are getting all medications refilled on the same date at the same pharmacy. "By consolidating the refills dates, you have reduced the inconvenience of having to make multiple trips to a pharmacy," Nau said. "This could also allow the pharmacist to schedule an appointment with the patient on the refill date, so that the pharmacist can talk with the patient to ensure that he or she has no problems with the medications and is achieving therapeutic goals. …

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