Pharmacist management improves blood-thinner adherence

Yet another study has reinforced what several others have also documented - pharmacist involvement in patient care improves medication adherence and healthcare outcomes.

The latest study, involving a new type of blood thinner, was co-authored by a researcher at the Stanford University School of Medicine and was published in the Journal of the American Medical Association.

Brief pharmacist intervention key to improved med adherence

It found that patients are more likely to take dabigatran correctly and not miss doses when they were managed by pharmacists instead of solely by doctors or nurses.

Specifically, researchers studied Veterans Health Administration (VA) patients given dabigatran prescriptions by VA pharmacists who provided education about the blood thinners and monitored the patients. Patients who received the additional attention from pharmacists were 80% more likely than other patients to take the medications properly.

"The new oral anticoagulants, such as dabigatran, represent the biggest medical change in in the delivery of care for AFib patients," said Mintu Turakhia, MD, assistant professor of medicine at Stanford and senior author of the study. "Before, the only option we had for patients was warfarin, which is cumbersome and requires blood testing once or more per month."

"Although pharmacist-led management of these new drugs is uncommon in the [United States], the findings make the case that it is still important and can ultimately impact clinical outcomes," Turakhia said.

Turakhia and his colleagues studied patients at VA sites where at least 20 outpatients received dabigatran prescriptions between 2010 and 2012. They found that medication adherence rates varied by site. Researchers then interviewed managers and pharmacists at 41 of the VA facilities.

They found that the sites with the highest adherence rates usually had a pharmacist involved with patient education and follow-up.

"We determined there was a high level of scrutiny and review to make sure patients were getting the drugs," Turakhia said. "There was a lot of consideration of the dose, interaction with chronic kidney disease, and review to make sure that patients should be getting these drugs."

Turakhia added: "We're suggesting that greater structured management of these patients, beyond the doctor just prescribing medications for them, is a good idea. Extra support, like that provided in the VA anticoagulation clinics with supportive pharmacist care, greatly improves medication adherence."