Improving the sub-par adherence report card

One of the most effective levers pharmacists and other health professionals can pull to curb the nation’s $2.7 trillion healthcare bill is boosting patients’ adherence to their prescription drug treatment regimens. But who’s holding the handle?

That’s one of the questions raised by a new study on patient adherence rates by the nation’s top independent pharmacy organization. In its first National Report Card on Adherence, the National Community Pharmacists Association gives U.S. adults ages 40 and older only a so-so grade of C+ overall, and says 1-in-7 of those medication users rate an F. “Millions of adults ages 40 and older with chronic conditions are departing from doctors’ instructions in taking their medications – skipping, missing or forgetting whether they’ve taken doses, failing to fill or refill prescriptions, under- or over-dosing, or taking medication prescribed for a different condition or to a different person,” NCPA reported.

Factors like the out-of-pocket cost of a prescription and the patient’s age — older patients tend to adhere more to their drug therapy than do younger ones — play a big part in adherence rates. And of course patients tend to skip their meds if they don’t want to deal with the side effects, or if they don’t perceive the drug’s long-term benefit. But in a big way, success in the campaign to boost adherence is about relationships, NCPA’s findings suggested. Patients who have a long-term, sustained relationship with a particular physician and/or pharmacist tend to stay on their medication regimens more than those who don’t.

“Adherence is higher among patients who see the same health care provider each time they have a medical appointment, compared with those who see the same provider less frequently,” the report says. “These results suggest the power of patient/provider relationships in prescription drug adherence.

“Feeling connected with the pharmacist or pharmacy staff or having a continuous relationship with a health care provider likely facilitates communication, boosting greater adherence among these groups.”

Critical to that effort is pharmacist involvement, or — to extend the analogy at the top of this blog — to make sure pharmacists can grab the lever and pull effectively. Says NCPA in its report, “Pharmacists have a role at the forefront of addressing prescription medication non-adherence. The results of this survey indicate that much depends on the extent to which pharmacists and pharmacy staff establish a personal connection with their customers and engage with them to encourage fuller understanding of the importance of taking medications as prescribed.”

To that end, NCPA asserts, “Independent pharmacists may be particularly well placed to boost adherence, given their greater personal connection with patients.”

Tens of thousands of dedicated and fully engaged chain pharmacists who have worked hard to establish rapport with their patients and build clinical-care programs might take issue with that assertion. As reported last week by Drug Store News associate editor Alaric DeArment, “The biggest predictor of patients' adherence overall was their connection to pharmacists or pharmacy staff.”

Examples of collaborative programs among pharmacists and regional health organizations to boost adherence among specific groups of patients abound. Please share yours by clicking on the comment button, because sharing ideas and best practices can boost adherence efforts overall.