According to research, approximately 50% of patients do not take their medications as prescribed. This is said to be due to several factors, like the cost of medications, forgetfulness, and complexity of the medication regimen.
Improving medication adherence is one of the crucial responsibilities of pharmacists because, according to the World Health Organization, adherence to medication can have a more direct impact on patients’ health outcomes than even the treatment itself.
A pharmacist’s job doesn’t end with prescribing and refilling medications; it extends far beyond that to ensure that the patient achieves optimal health and clinical outcomes.
This blog post explores the key roles of pharmacists in improving medication adherence.
What is Medication Adherence?
Medication adherence can be defined as the extent to which a patient follows their prescribed medication and its regimen. It covers the intake of the proper medication at the right time, in the correct dosage, in the right way, and without any uncontrolled self-medication practices.
For example, using the right medication at the right time and in the correct dosage with herbal medicine does not equate to medication adherence.
For adherence to be considered, the patient must strictly follow all instructions given by the pharmacist or the healthcare provider regarding the medication.
Factors that Affect a Patient’s Medication Adherence
Different factors affect a patient’s non-adherence to medications. Usually, these factors are specific to the individual, but they can include:
Medication Cost.
Socioeconomic factors have been implicated in the cause of non-adherence multiple times. The cost of getting prescribed medications, especially for people without medical coverage, can be enormous. It is usually amplified in patients who have to manage chronic conditions and need to purchase medications constantly.
Usually, these people are only able to get the medication when they can, leading to non-adherence to their medication regimen.
Busy Schedules.
This factor applies to business owners, busy moms, office workers, etc. When you have a busy schedule, it is easy to forget about a prescription refill until you need to take your medications and discover that your supply has been exhausted. Busy schedules also prevent patients from showing up for appointments.
Promptness of Access.
As much as the survey suggests that almost 90% of Americans live within 5 miles of a pharmacy, promptness of access to pharmacy care remains one cause of medication non-adherence. This indicates that the ease of access might have to do with the pharmacy’s mode of operation.
For example, the workflow in some pharmacies is faster, which helps to reduce patients’ wait times for medication dispensing or consultation.
Understanding Medication Usage.
A lack of understanding of medication usage automatically leads to non-adherence. The patient will either end up taking the wrong dose, taking the medications at the wrong time, or taking them in the wrong way. This is why effective communication and constant medication counseling are essential in improving medication adherence.
Forgetfulness.
Forgetfulness can be a result of busy schedules or deteriorating health conditions, especially in cases of dementia, Alzheimer’s, etc. This can lead to non-adherence to medications.
Severity of Health Condition.
The severity of a patient’s health condition can also lead to non-adherence, especially when this severity directly impacts mobile access to pharmaceutical care.
For example, an older adult with limited mobility might be unable to attend a physical appointment or get prescription refills.
Cultural Beliefs.
Some cultures do not support the use of medications, and some might have preconceived notions about them. Cultural competence is a needed skill in improving medication adherence in pharmacy practice because it will equip the pharmacist to navigate non-adherence based on cultural beliefs.
Previous Treatment Failures.
Disappointment with previous treatment can discourage patients from adhering to their medication routine. They might be more inclined to try other alternative therapies regardless of whether they are medically safe.
Role of Pharmacists in Improving Medication Adherence
The role of pharmacists in improving medication adherence is of utmost importance. Pharmacists are usually the last point of contact before a patient begins their treatment or medication routine.
Although medication adherence is not the sole responsibility of the pharmacist, this profession’s unique position on the healthcare team can significantly affect the effectiveness of the overall measures taken to ensure patient medication adherence.
Here are some practical ways pharmacists can improve patient medication adherence:
Determine the Level of Adherence.
Before making decisions on the patient’s medication adherence, like changing their medication therapy, pharmacists should first assess the level of adherence and identify the patient’s reasons for non-adherence.
This will help to create a more targeted and effective intervention to enhance the patient’s compliance with their medication regimen.
Different methods can be used to assess medication adherence, including questionnaires, laboratory tests, and electronic monitoring.
Offer Quarterly Medication Reviews.
Quarterly medication reviews or medication reconciliation involve reviewing all the patient’s medication records and devising ways to enhance medication adherence every three months.
However, the problem with medication reviews is that the patient might not supply all the necessary information. For example, a patient might be reluctant to disclose to a pharmacist that they are using herbal medications alongside their prescribed drugs.
This is why a pharmacist must establish a strong patient-pharmacist relationship in which patients can feel comfortable disclosing all information relevant to their health.
Recommend the Use of Digital Apps.
Telepharmacy services are on the rise, and for patients who value ease of scheduling and prompt access, digital apps can be a game changer and help improve medication adherence.
Various effective digital apps, such as Arine, DAWN, Digihaler, etc., can be used to monitor patients in real time.
Encourage Early Refills.
Early refills, e.g., 5-7 days before the next fill and when most health plans permit, can benefit patients with busy schedules who are not readily available for a pharmacy visit.
Encouraging these patients to come in for early refills will prevent them from missing their daily dosage due to exhausted medication stock.
This is a preventive measure to improve medication adherence.
Optimize Patient Medication Counseling.
Patient medication counseling is one of the strategies that pharmacists can implement to improve medication adherence.
Optimizing patient medication counseling involves offering personalized advice to patients based on their unique circumstances.
It begins with understanding their reasons for non-adherence and collectively devising effective strategies to combat the barrier to adherence.
Encourage Single Pharmacy Usage.
As much as electronic health records can help provide a comprehensive overview of a patient’s medical records, they can be ineffective if the patient constantly changes pharmacies or health institutions.
Filling prescriptions in multiple pharmacies can make it difficult to track medications over time. For starters, not all pharmacies have implemented electronic health records.
Also, using a single pharmacy increases the likelihood of the patient’s records being reviewed by the same pharmacist. This will help ensure proper medical reconciliation and review of the medications to predict drug-drug interactions and possible adverse drug reactions accurately.
Simplify Medication Regimen.
Simplifying medication regimens can help pharmacists in improving medication adherence in their patients.
It can be challenging to keep up with complex medication regimens, and pharmacists should develop effective, tailored strategies to simplify these medications.
For example, a pharmacist can help deprescribe ineffective medications, simplify dosing schedules, or compound medications.
Here’s a relatable scenario:
A pregnant woman is given her prenatal medications but cannot adhere to them because she has to take multiple pills at different times of the day. The pharmacist then recommends another prenatal medication, in which all her needed vitamins are compounded into a single pill and taken once a day. This medication routine is the best solution for her because it’s simple and easier, and she’s happy to adhere to it.
Recommend Keeping a Medication List.
A medication list helps ensure proper medication review and reconciliation, especially in emergencies.
The medication list should include the drug’s name, dosage, start date of the regimen, and purpose of use.
Pharmacists should encourage their patients to keep this list and bring it with them when they visit the pharmacy.
Utilize Mobile Text Messaging.
Pharmacists can utilize text messaging in improving medication adherence.
This involves sending medication pick-up reminders directly to their patient’s mobile devices, reminding patients to refill their prescriptions when the prior one is almost exhausted, and sending appointment reminders.
Thanks to technological advancements, mobile text messaging can be integrated into other telepharmacy services and platforms and is available to anyone of any age or socioeconomic group.
Leverage the NCQA Resource Platform.
The National Committee for Quality Assurance (NCQA) understands the need for improved medication adherence. It has built a suite of resources to assist healthcare professionals interested in improving medication adherence among their patients.
This resource helps with communication and patient education. It contains practical tips and tools that healthcare professionals can use to improve communication with patients about their medications.
It also contains patient medicine education guides for both the patient and the healthcare professional, discussion guides for the patient’s follow-up call, how to set up medication quality improvement guides, etc.
Conclusion
Improving medication adherence is a big deal in the pharmaceutical industry.
Medication adherence is vital in ensuring patients take their medications correctly to achieve better health outcomes. Pharmacists have a crucial role in this because they are often the last people patients see before starting their medications.
By understanding each patient’s reasons for non-adherence, pharmacists can develop targeted interventions that address these specific reasons.
Pharmacists can encourage patients to utilize digital apps, come in for early refills, and stick to a single pharmacy.
On the other hand, pharmacists can equip themselves in improving medication adherence through professional training or development. For example, they can utilize the NCQA resource to learn how to discuss medication with patients more effectively.
Pharmacists can also optimize medication counseling and learn how to simplify medication regimens for their patients.
Medication adherence is achievable but requires the collaborative efforts of all healthcare system members and patients. Let’s work together to improve the health outcomes of the general public.
Comments