Pharmacists Could Boost Drug Adherence
Community pharmacists can dramatically help their patients stick to their prescription regimens, according to a study led by researchers at the University of Pittsburgh School of Pharmacy. The findings, published on August 4th 2014 in Health Affairs, suggest also that greater adherence to medications can lead to a reduction in emergency room visits and hospital admissions, thereby lowering health care costs for a variety of chronic conditions including diabetes and asthma.
A release from the university reports that about 70 percent of all Medicare patients get their prescriptions filled at neighborhood drug stores. Yet lead investigator Janice Pringle, Ph.D., associate professor and director of the Program Evaluation and Research Unit (PERU) at Pitt’s School of Pharmacy, said that pharmacists can do more for patients than just prepare medications. She noted that their training, knowledge, and community accessibility may make them the ideal health professionals to help people learn how and why to take their medications.
The release quotes Dr. Pringle as saying, “This untapped resource could be harnessed and used to improve public health and reduce overall health care costs. If people took their medications as prescribed, diabetes would not evolve and worsen, blood pressure would normalize, cholesterol would be reduced dramatically, and the risk for severe health problems, such as heart attack or stroke, would be reduced. Patients would live longer and probably enjoy a higher quality of life.”
For the study, dubbed the Pennsylvania Project, 283 community pharmacists were trained at short workshops by PERU staff to ask customers a few quick questions about medication adherence using established survey tools. They also were taught to have a brief dialog with patients whose screening scores indicated they were at risk of not taking their medications as prescribed by their doctors. The conversation might include questions and reassurances about side effects or to request that the patient talk to the pharmacist after taking the medication for a little while to report how they were feeling.
During 2011, 29,042 people had prescriptions filled at 107 Rite Aid pharmacies that implemented the screening and brief intervention approach (SBI) and 30,454 people who went to 111 “control” pharmacies that didn’t use SBI.
The research team then reviewed insurance claims data to evaluate medication adherence with a measure called “Proportion of Days Covered” or PDC. A PDC of 80 percent, meaning the medication was taken for at least 80 percent of expected period, is considered to be the minimal medication dose needed to achieve the desired clinical outcome. PDC80 values were calculated for both the intervention year and for 2010, the year prior to SBI implementation.