Depending on which study you read, between 20% and 50% of patients do not take their prescription medications as directed. Often patients try to follow through, but they are stymied by high costs, formulary restrictions, confusion about when and how to take their medications, and having to juggle multiple regimens at once, among other obstacles.
These breakdowns are estimated to account for 10% of all hospital admissions and 125,000 deaths each year. And the risks only increase for patients taking complex drug regimens over extended periods of time.
Fortunately, there are many practical steps health care providers can take to support patients, including thorough medication reconciliation; optimizing the medication regimen by adding or removing drugs as appropriate; removing barriers to access; patient education; and ensuring patients know where to turn with questions.
Often involving pharmacists directly in patient care yields even better results. Below are lessons from two highly successful pharmacist-led programs.
Make it personal
Kaiser Permanente’s Diablo Service Area in Northern California developed a pharmacist-led medication management program for chronic myeloid leukemia (CML) patients on oral tyrosine kinase inhibitor (TKI) regimens. The program increased the percentage of patients who remained on their treatment plan to 88.6%, compared with 65.8% of patients who received usual care.
According to the lead author of the study, one of the keys to success was that pharmacists were able to establish “close and trustworthy” relationships with patients at clinic visits. Patients first meet with an oncology pharmacist immediately after diagnosis. They then developed those relationships over time—often over years—through clinic visits, phone calls, and email.
Make it convenient
The CML patients especially appreciated being able to contact the pharmacists by email. Kaiser’s pharmacists and CML patients are in contact once every three months on average.
Remind patients about their goals
To help patients stay motivated, the Kaiser pharmacists incorporate data into their conversations with CML patients about how their medications reduce the likelihood of relapse. By reminding patients about the benefits of their therapy, they help patients to refocus on their goals and the practical steps they can take to achieve them.
Simplify the dosing schedule
Freedom Pharmacy and Wellness Centers and specializes in working with patients with cystic fibrosis (CF). It’s not usual for CF patients to have to take 20 or more pills each day over the course of their lifetimes. The medication regimen is not only a lot to manage, but also it can be a source of embarrassment, especially for younger patients. In response, the pharmacists at Freedom Pharmacy work with patients’ physicians to substitute higher dose versions of their drugs which can be taken less frequently.
Provide positive reinforcement
Freedom Pharmacy provides rewards for CF patients who stick to their treatment plan. Each month patients who follow their medication regimen earn “healthy bucks.” Patients can then redeem their “healthy bucks” at Freedom Pharmacy/Cystic Fibrosis Pharmacy’s online store over-the-counter pharmacy and health products, such as sunscreen and aspirin.