Five ways to improve patient medication adherence

O'ConnorOut of $213 billion in avoidable annual healthcare costs, $105 billion is due to medication nonadherence, according to a recent IMS Health Informatics study. In addition to the potential cost savings associated with improved adherence, it could also lead to better health outcomes, such as reduced readmissions and reduced viral loads among patients with infectious diseases like HIV.

Related: Updating the U.S. healthcare playbook

Simply put, as the healthcare system moves away from fee-for-service to value-based pay, improving patients’ adherence to medication therapies moves both the numerator (outcomes) and the denominator (costs) of the healthcare value equation in the right direction.

The big question is how?

Here are five ways healthcare organizations of all types, including managed care organizations, can improve patient adherence to prescribed medication therapies.

Five ways to improve patient adherence

1. Tap the knowledge and accessibility of the pharmacist

On average, physician interaction with a patient lasts eight minutes, about 12% of his or her time on the job, according to a study published in The Journal of General Internal Medicine. A separate study, appearing in Patient Education and Counseling, indicated that physicians spend less than 60 seconds discussing prescription medications with patients.

Related:Four ways clinical pharmacists can improve managed care

Internal research conducted by Vickie Andros, PharmD, director of clinical services for Curant Health, revealed that Curant Health clinical pharmacists spend 21 minutes with patients per interaction. This is more than double the average time physicians spend with their patients.

Clinical pharmacists have the time and expertise to help fill in the gaps when physicians lack the necessary time to discuss medications with patients.

NEXT: Demand more from medication therapy management (MTM)

2. Demand more from medication therapy management (MTM)

Medication therapy management is a broadly used term that, at a minimum, encompasses five elements: 

• Medication therapy review

• Development of a personal medication record

• A medication-related action plan

• Intervention and/or referral

• Documentation and follow-up.

A majority of pharmacies limit their MTM programs to just these basic elements.

Enhanced MTM programs engage two key patient support teams to treat the whole patient: highly-skilled, outcomes-focused pharmacists and dedicated personal care coordinators.  

Related:Better health, lower costs the result of incorporating pharmacists in the management of complex patients

In a 2012 study of HIV patients on highly active antiretroviral therapy, patient adherence increased by 28% via an enhanced MTM program. The percentage of HIV patients whose viral loads were considered undetectable increased from 28% to 66%. This improvement in viral suppression resulted in cost savings of $3,000 per patient per year.

3. Invest in compassionate, human resources

Patients assigned a care coordinator who monitors them through weekly or monthly calls and ensures patients are following their personalized medication regimens demonstrate higher levels of adherence. This level of care also encourages patients to take more responsibility for their own care.

This may appear intensive from a human resources standpoint. It can be. However the adherence gains made by investing in regular, direct, personal patient engagement outweigh the associated costs when incorporated with other elements of effective enhanced MTM.

Next: Carefully evaluate the whole patient

4. Carefully evaluate the whole patient

In evaluating the whole patient, especially patients suffering from chronic illnesses like HIV, hepatitis C and others, place the patient at the center of every conversation.

Look beyond the disease or the symptoms to uncover other drivers of barriers to medication adherence and improved health outcomes.

What other medications is a patient taking? What are the side effect implications and how can the patient mitigate them? What is their lifestyle and level of education?  Are there barriers to adherence like cost, access to care or need for further education? 

Related:The new patient-centered pharmacy

In addition to developing trusting relationships with patients, effective, capable and empowered MTM pharmacists frequently serve as the link between patients’ multiple healthcare providers, reducing workloads for many care-team stakeholders and making real-time pharma-analytics available to those providers.

5. Provide copay assistance, identification, and activation

Financial inability is a prime factor of patient nonadherence. If the affordability of high cost, specialty medications increases, especially for patients suffering from chronic illness and infectious diseases, patients will be more inclined to adhere to their prescribed regimens.

Patients who think they adequately planned for healthcare expenses by enrolling in insurance plans, or enrolling in high deductible plans, can find themselves overwhelmed with expenses of insurance copays for prescribed therapies. This burden prevents patients from complying with their treatment plans and forces them to either choose between medications or go without entirely.

Organizations that provide dedicated copay assistance identification and activation for their patients positively affect both sides of the value equation in value-based care, where value equals outcomes divided by costs.

Marc O’Connor is chief operating officer for Curant Health. Curant Health treats patients nationwide through its medication management protocols.