In last week’s blog, I discussed a new report from the Agency for Healthcare Research and Quality (AHRQ) that reviewed evidence from 68 scientific articles in an effort to determine which interventions are most effective in improving medication adherence.
This report noted that effective interventions include case management education, reminders, pharmacist-led approaches, decision aids, reducing out-of-pocket expenses, improving prescription drug coverage, and collaborative care. Furthermore, the report noted that the first three in that list have the strongest evidence for effectiveness.
The gap between expected medication effectiveness in treating a disease and its real-world effectiveness is generally accounted for by patient adherence. In other words: medications can’t work in patients who don’t take them. Patient non-compliance with a treatment plan is fairly common. According to research, up to 30 percent of prescriptions simply never get filled by patients. Furthermore, when looking at patients with chronic diseases, half of medications are not taken as prescribed.
The AHRQ report authors are quick to note that there simply is no “silver bullet” available that will resolve all patient hurdles and bring about complete medication adherence. I agree with this assessment and I would also like to point out that it’s important to know where we are aiming before we shoot.
This is why, at BioPlus Specialty Pharmacy, we study our own internal data in an effort to improve patient outcomes. For instance, we review the compliance history of each patient when admitting them. This provides invaluable information about what to expect with the patient and which kind of aid or interventions might improve their adherence.
Similarly, even for the occasional patient who fails to have a successful treatment outcome, our specialty pharmacy takes the time to learn why: which point in the therapy process did the patient fail and what could we do differently.
Consider the treatment of the hepatitis C virus (HCV). It’s not uncommon for anemia to develop as a side effect of HCV treatment. We educate our patients to this possibility and even take it a step further and turn it into a positive in our patients’ minds. We explain that the development of anemia can be an indicator that medications are working. Research shows that HCV patients who become anemic during treatment are actually more likely to clear the virus. Our patients, when properly educated, are then able to identify the anemia, contact us or their doctor, and have their medication dose appropriately reduced while staying on track for a sustained viral response.
Each intervention made to close the gap on patient non-compliance brings us closer to the best treatment outcomes for the greatest number of patients.
Stephen C Vogt, PharmD
President and CEO