Improving patients medical adherence

Poor medical adherence is a major issue.  Approximately one in five new prescriptions are never filled.  About half of filled prescriptions are taken incorrectly.

Poor adherence is getting greater.   A push to the payment to quality of care means more focus on adherence.  It started with Medicare Star Ratings and adherence to statins, AEIs or ARBs, and non-insulin diabetes meds.

More payers are following suit.  There are new financial rewards and risks with MTM and pay-for-performance for example.  Pharmacists’ role is critical, and they will see adherence tied to their performance review or bonus.

Pharmacists are encouraged to streamline their efforts to help patients take their medications properly.  First, ensure meds are appropriate, safe, and effective during DUR, counseling, or comprehensive med reviews.

Capitalize on opportunities where you can make a big impact.  Consider new prescriptions as opportunity to start therapy off right.  Encourage your techs to try to find out why patients aren’t picking up prescriptions for chronic conditions before returning meds to stock

Try motivational interviewing to identify each patient’s unique challenges, and work together to find solutions.  For example, if cost is an issue, suggest therapeutical alternatives or tablet splitting, or to reduce complexity, consider med sync, 90-day prescriptions, or combo meds.  Suggest reminders, such as pillboxes, smartphone apps, etc.

Offer support at each patient visit or phone call.  Adherence can change over time.  For example, ask how patients take their meds, or what concerns they have.

Consider involving prescribers if patients fall too far behind on refills or don’t pick up new prescriptions.  And tell your techs to watch for payer and MTM alerts for late refills.