Medication Compliance Opportunities, Part 1

While everyone agrees that better medication adherence would improve treatment outcomes and save money—what isn’t so clear-cut is which methods are the most effective to achieve this goal. The Agency for Healthcare Research and Quality (AHRQ), which is part of the U.S. Department of Health & Human Services, recently stepped into this discussion.  

Reports released by AHRQ have the goal of improving health care quality in the United States. Recently the AHRQ sponsored a report based on new research about medication noncompliance. According to this new report, when it comes to patient medication compliance, the interventions with the most effective results are: 

    • Case management education
    • Decision aids
    • Reducing out-of-pocket expenses
    • Improving prescription drug coverage
    • Collaborative care
    • Reminders
    • Pharmacist-led approaches 

Of the interventions listed in the above list, the AHRQ concluded that the strongest evidence for improved medication adherence lies with educational and case management interventions (which include reminders and pharmacist-led multi-component interventions). 

This AHRQ report reviewed evidence from 68 scientific articles (most of which were randomized controlled trials) in its consideration of medication adherence interventions. The study authors noted overall that “…numerous pathways provide opportunities to improve medication adherence across clinical conditions. These approaches include relatively low-cost, low-intensity telephone and mail interventions. They also include some relatively intense interventions, such as care coordination and case management…”  

With that in mind, however, the study authors felt that “…educational interventions and case management approaches offer the most consistent and voluminous evidence of improvements in medication adherence across varied clinical conditions.” Intervention programs to better patient compliance can be targeted in one of several areas, namely the patients themselves, the prescriber, the health system, or at a policy level.  

Policy-level interventions were deemed by this report to have positive effect on medication adherence, such as those that lower the out-of-pocket expenses of patients on prescription medications (e.g., lower medication copayments or better prescription drug coverage).  

Considering the fact that noncompliance has a significant health care cost down the road for patients, any policy that improves adherence may end up being very cost-effective for the system. 

Next week, I’ll continue this two-part blog on the AHRQ report and highlight how BioPlus Specialty Pharmacy conducts internal reviews to maximize patient adherence.

Stephen C Vogt, PharmD
President and CEO
BioPlus SP

1.Closing the Quality Gap: Revisiting the State of the Science Series: Medication Adherence Interventions: Comparative Effectiveness. Structured Abstract, September 2012. Agency for Healthcare Research and Quality, Rockville, MD.
2. Executive Summary. Closing the Quality Gap Series: Medication Adherence Interventions: Comparative Effectiveness. Evidence Report/Technology Assessment Number 208. Sept. 11, 2012.

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