Poor medication adherence is a nationwide problem. So which healthcare professionals are working hardest to overcome this issue? The latest NCPA Digest report strengthens pharmacists’ claim to this tag.
Strong Pharmacist Support for Adherence
Pharmacy chains like Walgreens and CVS have shown strong commitment to improving adherence. Their respective WellTransitions and Pharmacy Advisor programs (see here and here) are examples of this. Now the National Community Pharmacists Association (NCPA) has released new information. Their 2012 Digest provides interesting new insights into how hard community pharmacies are also working to advance patient adherence.
The NCPA Digest reviews the current status and activities of over 23,000 independent community pharmacies. Just considering activities to improve medication adherence, the Digest confirms how strongly these pharmacies are working to address this issue (see here and here):
- 50% of independent community pharmacies offer programs to improve adherence
- 48% offer adherence counseling services (up from 39% in 2011)
- 39% offer phone or text reminder adherence reminders (up from 22% in 2011)
Another NCPA document (see here) lists several other ways in which independent pharmacies are tackling adherence. These include medication therapy management, compliance packaging, synchronized refills, and motivational interviewing.
The Digest also noted that community pharmacists helped reduce healthcare costs by dispensing a record number of lower-cost generic drugs (76%, up from 72%). They also on average consulted with physicians almost 8 times a day about drug therapies. This included advice on appropriate use of generics. Pharmacist recommendations were accepted by physicians 83% of the time.
In connection with this last point, it should be remembered that pharmacists are consistently ranked in the top 3 most trusted professionals (see here).
Adherence Solutions Aligned to Patient Needs
Among the more common reasons for patients not adhering properly to medication regimens are cost, forgetfulness, lack of understanding , and mistaken beliefs.
Based on this latest Digest information, community pharmacists are well-placed to address adherence issues relating to any of these four reasons. For example:
Cost can be addressed by use of less expensive generic alternatives.
Forgetfulness may be addressed through use of reminders or compliance packaging, both of which help patients take their medications according to plan.
Lack of understanding (eg, regarding the importance of therapy and adherence) can be improved through education – which is typically a part of medication therapy management – and through counseling.
Mistaken beliefs may also be addressed by counseling and education, for example focusing on the value of treatment and the importance of adherence. Motivational interviewing can also play a role in such situations.
The easy availability of pharmacists, their approachability, and their highly trusted status all add to the value community pharmacies can bring to improving adherence.
Two comments come readily to mind relating to this latest pharmacist report.
Firstly, it’s essential to correctly match adherence solutions with identified patient reasons for non-adherence. For example, reminders can be effective when patients intend to take their tablets, but just forget to follow through (eg, due to interruptions or schedule changes). If patients lack commitment (eg, because of poor understanding or mistaken beliefs) reminders are less likely to be effective answers.
Secondly, the reported frequency of pharmacist-physician discussions opens up further opportunities to enhance adherence. Poor adherence has proved a tough nut to crack. The more healthcare professionals (HCPs) can work together, the better the chances of success. Regular exchange of relevant information will help get pharmacists and physicians on the same page. Through this, patient-specific adherence actions can be reinforced by both HCPs, which can surely help to further improve adherence.
Additional comments welcomed!