The gender gap in Rx adherence: Can pharmacists bridge the divide?

Powerful pharmacy benefit manager Medco Health Solutions has just unveiled the results of a large-scale study that points out the critical role that pharmacist interventions play in the health and safety of women.

The results of the research, jointly conducted by Medco and the Society for Women's Health Research, came to light March 17 at Women's Health 2012: The 20th Annual Congress. The study shows a wide and worrisome gender gap when it comes to how men and women adhere to their medication regimens.

Despite the fact that women of all ages use more drugs — an average of five compared with 3.7 for men — they’re less likely to adhere to their prescribed drug regimens, and aren’t “prescribed treatments in alignment with recommended guidelines as often as men,” according to Medco.

“Differences were most dramatic among patients with cardiovascular disease and diabetes,” noted researchers. “Men far surpassed women when it came to diabetic adherence to prescribed medications, monitoring and management tools.”

Women also fared significantly worse than men in adherence rates for cholesterol reducing drugs and other medicines used to manage cardiovascular disease, the No. 1 killer of women in the United States.

The gap in adherence rates “could be due to a variety of reasons,” according to Medco, “including adverse side effects, inability to tolerate the medication, or failure among women to see or feel improvements in their health.” But another culprit, noted researchers, could be the fact that women are often prescribed drugs in dosages appropriate to men but not women.

“It has long been demonstrated that there are physiological differences in women that affect their absorption and metabolism of medications,” noted Amy Steinkellner, PharmD, national practice leader for Medco Women's Health Therapeutic Resource Center.

The research project wasn’t just an academic exercise; it points up real challenges for pharmacists, physicians and other professionals responsible for managing the health and wellness of millions of women. Among patients with cardiovascular disease and diabetes, Medco reported, “women showed poorer outcomes than men in 25 out of 25 clinical measures.”

That’s a striking piece of news, and it’s something every pharmacist should bear in mind as they dispense medicines and consult with their female patients. “It is critical to consider gender in every aspect of drug development and management, from research and reporting of results all the way through to a personalized medicine treatment plan,” said Steinkellner.

“We need to … commit to understanding all the factors that affect [women’s] adherence to medications for the long-term,” added Phyllis Greenberger, president and CEO of Society for Women's Health Research.

If you’re a practicing pharmacist, resident or pharmacy student in rotations, we’d like to hear from you. Have you encountered situations in your interactions with women patients that hint at the challenges to medication adherence highlighted by Medco? Please share your thoughts and experiences below.

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