Lessons Learned From Zac

AJPB® Translating Evidence-Based Research Into Value-Based Decisions®, May/June 2015, Volume 7, Issue 3

Taking steps to improve medication adherence, starting with simple outreach efforts.

It is a well-known adage that we should look around us and learn from others, and I have always found this to be true, but never so true as with a recent experience in dealing with my dog, Zac’s, veterinarian. This spring, Zac became sick with dog influenza (yes, this is a real condition and became an epidemic in Chicago). Twenty-four hours after we received the medication to treat this condition, the veterinarian called to see if we had any questions and to make sure we were not having any issues with treatment or side effects. Five days later, the veterinarian called once again to verify if the medication had any effect so far, along with a reminder that although Zac may begin to feel better, it would be important to complete the full course of medication.

The experience taught me a number of things. First, that the veterinarian understands there are several consistent natural risk periods for medication adherence, and secondly, that communication and empathy go a long way in addressing medication adherence issues.

It continues to amaze me that we don’t follow these same steps in the human healthcare world. The outreach that I received regarding my dog’s medication was not a highly complicated intervention, nor was it time consuming for myself or the veterinarian’s office, yet it did make a significant impression. Consider how a similar set of interactions could occur in our world, starting with an initial call-in order to make sure that the patient has filled their prescription and to check if they have any questions or concerns. We know that somewhere between 20% and 40% of individuals do not fill the prescriptions they are given by their physician, and we also know that patients often have questions regarding the medications prescribed. It has been shown that physicians may not always share important pieces of information regarding new medications, including the purpose of the medication, potential side effects, and the duration it should be taken. In addition to these gaps, most patients are only able to retain a portion of the information given to them at the time that a prescription is received.

The final piece of this adherence interchange is one that addresses the need to complete the medication course. While taking an antibiotic, how many of us begin to feel better and think that we no longer need the medicine? A simple reminder that there is a real reason to complete the course of treatment can go a long way.

So you may ask me, “Who should do these types of outreach?” My answer to you would be that there are several places where these calls could be initiated—the most obvious being the physician’s office. Granted, it does not have to be the physician himself or herself personally, it just needs to be someone that has the knowledge and specific information necessary in order to reach out and answer questions that may arise. Another starting place for these types of calls could be the pharmacy. I have often commented on the fact that pharmacists are an underutilized resource in today’s healthcare system, considering that they are the people that have the most knowledge around medications. It also is an excellent way to gain loyalty in the crowded and competitive retail pharmacy field.

I do not know if other veterinarians follow the same protocol as Zac’s doctor, but I do know it is something that we should all emulate in some fashion going forward. I wonder if Zac’s doctor takes human patients?