Getting through to non-adherent patients

In an ideal world, patients would take at least 80 percent of prescribed medication doses to maintain a drug's intended therapeutic effect. Unfortunately, patients on chronic medications stick to their regimen only about 50 percent of the time.

Non-adherent patients are more likely to experience treatment failures and serious adverse reactions. Medication non-adherence can also lead to hospital readmissions and expensive treatments that drive higher downstream healthcare costs.

From a business perspective, consistent medication adherence translates to increased prescription volume and higher revenue for independent pharmacies. What's more, when you help patients understand why they're taking their medications, you increase patient engagement, making it more likely that they'll stay on their prescribed course of treatment.

How to improve adherence

As a highly accessible and trusted expert on medication usage, pharmacists are ideally positioned to positively influence adherence. The following action items maximize opportunities to get patients on an adherent path.

1. Make adherence a priority

The Good Neighbor Pharmacy program provides tools and resources for monitoring and tracking patient adherence. For example, the Patient Engagement Center available through PrescribeWellness identifies patients taking diabetes, hypertension, and cholesterol drugs who fall below the 80 percent adherence threshold for their current therapy. In this way, your pharmacy information system helps you effectively identify those patients who need more attention and guidance.

The key is to commit to using the technology. Another helpful tool included in the  program, InSite, generates a suspect claims report and makes it available to member pharmacies every Monday night. This information helps you align with patients on adherence opportunities. Specifically, non-adherent patients taking three or more maintenance drugs should be counseled to enroll in medication synchronization, which offers them the convenience of consolidating refills.

Additionally, pay attention to your EQuIPP reporting, which shows pharmacy performance relative to Star Ratings measures. Here, you can run outlier reports to identify non-adherent patients so that you can work with them directly to get them moving in the right direction. Log on to EQuIPP at least once per week to gauge how your pharmacy is doing with tracked performance measures.

2. Build your understanding

Schedule time with your Good Neighbor Pharmacy business coach to walk through the previously mentioned systems so that you feel confident in what you're analyzing and how you can implement improvements in day-to-day operations. High-performing pharmacies use tools such as EQuIPP on a regular basis to find out how they are performing against proportion of days covered (PDC) measures thresholds and within health plans' quality improvement and/or pay-for-performance programs. Use reporting to uncover opportunities for matching up non-adherent patients with an appointment-based model such as med sync.

3. Delegate responsibility

Pharmacy owners often try to handle too much while running everyday operations. You may recognize the value of incorporating adherence initiatives but feel like you just don't have enough time to work them into daily activity. In truth, adherence responsibilities can be handed off to any trusted pharmacist or technician — someone who will take ownership of and accept accountability for improvement opportunities. When your whole team works collaboratively, you're less likely to get bogged down by incremental challenges.

4. Support your customers

While connecting with individual patients, focus on understanding their hurdles to find a solution for improving adherence. Adherence risk factors can range from lack of motivation and mental health to economic barriers or health literacy issues. While solutions like med sync have proven to be effective for a large portion of a pharmacy's patient population, pharmacies should be prepared to consider a range of solutions to meet patients' needs, including compliance packaging, 90-day supplies, medication therapy management (MTM), refill reminders, and delivery.

For instance, some patients may be open to receiving text reminders when it's time to take their medications. Others, especially those on complex drug regimens, may prefer having their pills pre-packaged in doses that indicate exactly when and how much should be taken. Be open to patient feedback and adjust over time until you find a solution that works.

In the end, you'll find that patients are receptive to assistance when it comes to managing their healthcare. When patients realize that you genuinely care about their wellbeing and start to recognize how their medication will positively impact their health, they're more apt to stay adherent. Accordingly, you'll see increased prescription refills over time.