Collaboration may improve medication adherence

Collaboration between pharmacy benefit managers and community pharmacists may improve patient compliance to vital drug regimens.

Patients who fail to adhere to prescribed medications cost the U.S. healthcare system an estimated $100 billion annually, according to a study published online in The American Journal of Managed Care. Researchers found that pharmacists who received regular alerts regarding patient adherence gaps were able to close more gaps than pharmacists who did not receive regular alerts.

“Collaborating with community pharmacists and providing necessary information to drive adherence and reduce omissions of essential therapies helps to improve health outcomes for patients,” according to Glen Stettin, MD, senior vice president of Clinical Research and New Solutions at Express Scripts, Inc.

Through prescription claims, Dr. Stettin, along with Daniel Touchette, PharmD, MA, assistant professor of pharmacy practice at University of Illinois at Chicago, College of Pharmacy, and colleagues identified 2,500 patients with diabetes, hypertension, high blood pressure, or heart failure who had gaps in medication adherence and omitted essential therapies. Patients were assigned to a participating pharmacy.

A total of 92 pharmacies participated in the study. Of those, 45 pharmacies received training on disease management, motivational interviewing, and communication. In addition, they were notified daily through an online portal of any patient gaps in care. The pharmacists then addressed these gaps directly with each patient and documented each interaction using the web-based tool.

Omission gaps were considered when a patient failed to receive a medication on their profile, and these were sent directly to the prescribing physician. The additional 47 control pharmacies continued to provide regular services. They did not receive specialized training or alerts for gaps in care.

At 30 days, the authors noted that medication adherence gaps were closed more often by pharmacists in the intervention group than those in the control group (55.5% percent vs 50.6%). At 90 days, pharmacists in the intervention group had closed 73.0% vs the 72.9% closed by the control group. Although the difference narrowed, it was statistically significant (HR=1.242; P=.022; 95% CI, 1.115-1.385).

The authors conclude that with the right support, community pharmacists can play an important role in validating and addressing medication adherence gaps.

“Pharmacists are in an optimal position to address therapeutic gaps in care,” the researchers wrote. “Community pharmacists are knowledgeable about potential barriers and solutions to adherence issues. They have frequent contact with their patients, know them well, and when needed, reach out to physicians on their behalf. They are also widely considered a trusted source for providing information to patients and practitioners about medication therapies.”

–Heather Onorati, Contributing Editor