Pharmacists, nurses prove most effective in promoting Rx adherence
A CVS Caremark-sponsored study looking at in-person, electronic, telephone, fax and mail communications that counsel patients to stay on their medications found that pharmacists in a retail setting are the most influential healthcare “voices” in promoting medication adherence.
The research, based on a review of more than 40 years of studies published in medical journals, found that pharmacists engaged in face-to-face discussions with patients in a store were twice as effective in boosting adherence rates as programs in which pharmacists talk with patients on the telephone.
Researchers also found that nurses talking with patients as they are discharged from a hospital are the second most influential voice in getting patients to take their medications as prescribed.
Patients with complex therapies struggle to stay adherent
Patients with chronic heart disease are likely to have several doctors and take nearly a dozen medications that are filled in at least two different pharmacies, resulting in many patients struggling to keep their medications straight, according to a study conducted by researchers from Harvard Medical School, Brigham and Women’s Hospital, and CVS Caremark.
Among the potential solutions: Create a “pharmacy home” to coordinate pharmacy care from a single point of contact. Researchers also said there is a need to synchronize medication regimens for patients because “those who make numerous trips to the pharmacy to pick up their medications, or fill prescriptions at different pharmacies, may have difficulty taking their medications as prescribed.”
Researchers found that during a three-month period, “10% of patients filled prescriptions for 23 or more medications … and 11 or more different drug classes, had prescriptions written by four or more prescribers, filled these prescriptions at two pharmacies and made 11 or more visits to those pharmacies.”
CVS explores cause, cost of nonadherence
Industry members would likely agree that those patients who are adherent to their prescription medications use less health care and have lower overall costs; however, how much adherence lowers total costs, why some patients do not take their medications as prescribed and whether what’s saved in health care offsets higher drug costs are among the questions that have not been as clearly understood.
To answer such questions, CVS Caremark inked a multiyear collaboration with Harvard University and Brigham and Women’s Hospital to better understand patient behavior and how the healthcare system can improve it — especially as it relates to medication adherence. Excess healthcare costs due to nonadherence in the United States are estimated to be as much as $300 billion annually. To date, researchers have unearthed a great deal of invaluable data aimed at curbing medication nonadherence. Some highlights appear on the following pages.