Reaching Across the Cultural Divide

Medication adherence is the most important predictor of patient outcome. Poor compliance to a prescribed treatment plan not only affects the individual patient, but affects the entire healthcare system. Improving medication adherence can result in substantial cost savings and improved outcomes, which are topics that I covered in my recent blog “Knocking Down Adherence Barriers” and in a blog last year “What You Don’t Take Can’t Help You.”

A white paper called “Blueprint for an Effective Cross-Cultural Medication Adherence Program,” looking at key factors contributing to medication non-adherence in U.S. ethnic minority patient populations, recently caught my eye. This paper correctly pointed out that a comprehensive adherence program needs to go beyond cost barriers and socio-economic obstacles to consider how culturally unique issues influence medication adherence.

I agree wholeheartedly: this is why all of our patient materials at BioPlus are available in 13 different languages. For something as complex as specialty pharmaceuticals for the treatment of diseases like hemophilia, hepatitis C, or cancer, there are many patients who will best understand their treatment plan in their native language. We understand that and want to remove every barrier we can to bring about successful treatment outcomes.

While medication adherence is a problem overall for patients, it is particularly acute in non-whites. As this white paper noted, non-adherence rates in Hispanics and African-Americans are much higher than those of non-Hispanic whites. Culturally-related barriers to medication compliance are unique to each ethnic minority but generally fall into one of four categories:

• Core health beliefs and practices
• Cultural norms, values, and customs
• Health-related communication styles
• Family dynamics

Not only are we up to this challenge here at BioPlus, we are already implementing tools to reach each of our patients, regardless of their ethnicity. If you’ll pardon me for tooting our own horn for a moment, we think we’re on the right track already with our high-touch patient programs to address and overcome compliance barriers. Our internal statistics show that from a sample of 22,200 patients being treated for various conditions at BioPlus, our compliance rate at discharge is 91 percent. Consider that the compliance rate for retail and mail-order pharmacies is generally only 50 percent.

When you consider that multicultural populations are expected to rise to 40 percent of the U.S. population by 2030, the importance of responding to multicultural barriers becomes increasingly clear.

Currently, Hispanics and African-Americans “index 20 percent lower in terms of adherence relative to non-Hispanic white patients,” says Marc Duquette, Vice-President of Corporate Development & General Counsel at Global Advertising Strategies. Breaking down multi-cultural barriers to adherence will only get more important in the future of specialty pharmacy.

Stephen C Vogt, PharmD
President and CEO
BioPlus SP

Global Advertising Strategies. Blueprint for an Effective Cross-Cultural Medication Adherence Program. February 2012.

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