The Medication Adherence Debate


How much of a role do pharmacists play in monitoring patient adherence?

Last month, the National Association of Chain Drug Stores (NACDS) and National Community Pharmacists Association (NCPA) issued a statement regarding 2 recent studies appearing in the Journal of Medical Economics (JME) and the American Journal of Managed Care (AJMC), regarding medication adherence.“The AJMC study effectively counters the claims in a study published in the JME regarding the uses of mail order versus community pharmacies. Amid these studies, it is safe to say that we have at least one important takeaway lesson: The best way to promote proper adherence to medication and better health outcomes is by ensuring patients’ access to the pharmacy of their choice. Despite repeated financial and other inducements encouraging mail order in Medicare Part D and other health plans, the vast majority of patients opt to continue to rely on their local, community pharmacist to help meet their health needs." (To read the statement in its entirety, click here.)

The recent news from NACDS and NCPA deals with an important issue concerning improving health care outcomes. There is much evidence that exists that supports putting patients on the appropriate medication and making sure that they adhere to the correct regimen not only improves their quality of life—but also reduces overall health care costs.

But which health team member should take responsibility for monitoring patient adherence? The tenure of the news release is that the patient’s personal pharmacist is in a much better position to do this than a mail order pharmacy just sending a 90-day supply. Although I agree with this perspective, I do wonder how many individual pharmacists have truly internalized that responsibility. How many have real programs in place to make sure it happens? Is such a program in place in your pharmacy?

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