Pharmacists Help Boost Adherence Rates

Specialty pharmacies are experiencing a growth spurt, especially in academic health system settings. But access to specialty medications is often difficult. 

Vanderbilt Specialty Pharmacy (VSP) at Vanderbilt University Medical Center in Nashville has developed a model that integrates pharmacists in its specialty clinics and the result has been increased patient adherence rates.

An outcomes study of VSP’s findings was published in the August 2017 issue of the Journal of Managed Care and Specialty Pharmacy.

Related article: Considering Specialty Pharmacy? Make Your Move

Autumn Bagwell Zuckerman, PharmD, a clinical pharmacist at VSP, told Drug Topics that between 2015 and 2016, under the integrated model, VSP had an average medication possession ratio (MPR) of 95% in 20 of their clinics. The industry average, she said, is 80%.

“The model we developed is integrating a clinical pharmacist physically into each of our specialty clinics. The pharmacist has access to the electronic medical record and is often side by side with either the physician and or the nurse in the clinic,” Zuckerman said. VSP has 30 pharmacists in 24 different clinics.

Zuckerman, the lead author of the JMCP article, said that pharmacists need to serve as the patient advocate, especially when it comes to managing specialty medications. “Gaining access to specialty medications is difficult, pharmacists can use their knowledge about these medications, the disease states they treat, and evidence-based medicine to make sure patients get the treatment that they need.”  [See Table 1]

Many specialty medications, Zuckerman noted, require high adherence rates for effectiveness. Pharmacists are able to not only support patients in taking their medication, but also ensure there are no financial barriers to continuing treatment as long as appropriate. 

Related article: Why Specialty Drug Prices Will Continue to Soar

Once patients start treatment, pharmacists monitor for adverse effects of treatment which may be either patient-reported, or identified through lab and clinical monitoring of the patient.

Zuckerman asserted that the integration of a pharmacist into specialty clinics enhances patient care in meaningful ways that benefit both patients and the entire health system. “If pharmacists are engaged from the initial clinical evaluation of a patient, they can play an active role in appropriate treatment selection, treatment initiation, and treatment monitoring.”

Zuckerman added that the VSP model has improved communication and coordination of care among the health-care team and treatment selection guided by evidence-based medicine and cost-effectiveness.

Zuckerman said that patients can be approved and treatment can be initiated faster with pharmacists’ involvement on the front end.