Pharmacist intervention improves medication adherence: Study

Community pharmacists can have a significant role in improving an entire patient population’s medication adherence, and its overall health, according to a study published in Health Affairs.

The study, led by Janice L. Pringle, University of Pittsburgh School of Pharmacy, found that Screening and Brief Intervention (SBI) is effective in improving medication adherence and reducing healthcare costs.  SBI is a process that involves screening patients for poor medication adherence risk, then providing patients who screen at an increased risk with brief interventions based on motivational interviewing principles. 

To implement the study, 283 pharmacists from a national community pharmacy chain were assigned to the intervention group. Collectively, they screened 29,042 patients for poor adherence risk and provided brief interventions to people with an elevated risk.  This group was compared to a control group of 295 pharmacists who provided only standard care to 30,454 patients.  Intervention group pharmacists were trained on SBI with minimal cost to the pharmacy organization.

Over a 1-year period, the intervention significantly improved adherence for 5 medication classes, from 4.8% for oral diabetes medications to 3.1% for beta-blockers. Additionally, there was a significant reduction in per-patient annual healthcare spending for patients taking statins ($241) and oral diabetes drugs ($341).

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In phase 1 of this study, community pharmacists received an online platform that measured their performance with respect to medication adherence and patient safety. 

“However, the pharmacists said that without having a clinical intervention that they could use to potentially improve their performance as evidenced by these metrics, they did not find the platform as useful in guiding improvements in their clinical quality,” according to Dr Pringle. “Thus, we designed the SBI interventions to be used in conjunction with the online quality platform.”

The study demonstrates that community pharmacists can have a significant role in helping managed care organizations meet their quality improvement efforts related to patient medication adherence. 

“The SBI process tested in this study could also be used by pharmacists with hospitalized patients prior to their discharge to support optimal medication use, and is thereby likely decrease untimely readmissions. The SBI process could also be used by physicians within primary care practices to support optimal patient medication adherence,” Dr Pringle said.

“Improving a patient population’s health can translate to significantly decreased healthcare costs for payers-commercial and public-and can increase the likelihood that Medicare vendors may secure federal incentives, such as via the Medicare Star Ratings program,” Dr Pringle.  “Heretofore, community pharmacists have not been recognized by most payers as an important vehicle from which to achieve these outcomes.”