Increasing collaboration among providers could improve medication adherence and patient outcomes.
Medication adherence is a constant struggle for pharmacists, especially those treating patients with conditions that require high-touch, high-cost specialty drugs. Missing just a single dose of medication may cause adverse health events or cost additional dollars spent on these patients. Preventing adverse events and extra costs are an important goal of specialty pharmacists.
Optimal adherence is linked to improved outcomes and reduced mortality for patients with chronic diseases, while non-adherence has been observed to increase the rate of hospitalization, poor outcomes, mortality, and health care costs, according to the CDC’s Morbidity and Mortality Weekly Report.
Current estimates indicate that of the prescriptions that are actually filled, only half are taken as prescribed. Patients typically struggle to adhere to therapies due to issues with timing, dosage, frequency, and duration, the CDC reported.
Improving medication adherence may save hundreds of billions of dollars each year, while also improving the health of numerous patients; however, significant barriers inhibit optimizing medication adherence and these factors vary among different patients and for each disease state, according to the CDC. A one-size-fits-all approach to medication adherence likely would not reach a majority of patients.
The CDC said that patient-related factors that impact adherence typically worsen with more complex drugs. These patients may forget to take their medications or not understand doses and scheduling, according to the report.
Patients may also choose to stop or change treatment due to financial concerns, beliefs, side effects, and expectations. The CDC said that patients may not be engaged in treatment decisions or have impaired cognition, substance use disorder, depression, and other mental health conditions.
However, providers also play a vital role in adherence. Problems communicating complex dosing regimens to patients and their caregivers could diminish adherence. Poor coordination among multiple providers also contributes to non-adherence, according to the CDC.
In the report, the CDC suggested multiple ways in which pharmacists could improve adherence, including the use of pillboxes and blister packs to keep medications organized in a very straightforward manner. Electronic pill monitors have also been shown to reduce unintentional non-adherence.
Pharmacists are increasingly incorporated into many multi-disciplinary teams, especially in the specialty space. These types of collaborative arrangements may also help improve patient adherence, according to the report.
Additionally, the CDC said that reducing financial barriers has also been proven to increase medication adherence. While reducing or eliminating co-payments may appear costly upfront, it may mitigate potential health events that necessitate more expensive medical procedures later in life.
The CDC’s Data to Care program identifies and reengages non-adherent HIV-positive patients by linking them to their providers, which improves the health of the patients while reducing the risk of transition. Approaches such as this can be effective for improving adherence, according to the report.
Technology—specifically e-prescribing—can also help encourage patients to fill initial and recurrent prescriptions. Digital health technologies can be used to track medication adherence.
Despite the significant potential for various interventions, the CDC notes that there have been few studies showing the benefits were maintained. Standardizing research may help address this gap, according to the report.
The CDC also suggests that patient-centered approaches that can identify the reasons for non-adherence and provide the necessary adjustments are crucial. For example, by providing populations known to have low health literacy with specific interventions, patients may be more likely to take their medications as prescribed.
The CDC concluded that understanding the causes of nonadherence and implementing cost-effective approaches that are applicable to various populations are key in improving medication adherence.