November 25, 2014
When patients aren’t adherent to their medications, it threatens their health and adds costs to the health care system. It’s not surprising that non-adherence is a big issue today, considering that half of older adults who take at least one medication report that adherence is challenging, and nearly 60 percent missed at least one dose of their regular medication last year.
Lack of adherence causes problems for everyone. Patients are more likely to experience complications that result in hospitalization, or to lose control of diseases that can normally be managed. And, your pharmacy will have trouble maintaining proper inventory and helping patients manage their conditions.
As a pharmacist, you are positioned on the front lines of the battle to improve adherence. However, in order to help patients comply with their medication regimens, you must be aware of the barriers to adherence that plague patients.
Here are some of the common difficulties that cause patients to miss a dose of their medication, and some ideas to help your patients overcome them.
Patients with multiple prescriptions that are due for refill on different dates can find it difficult to pick up their prescriptions on time. For some elderly patients, it might be impossible for them to find a ride to the pharmacy three of four times a month, and others might simply be too busy. Consider synchronizing their prescriptions so they can all be picked up on the same date. The 2014 NCPA Digest conducted by the National Community Pharmacists Association found that 90 percent of pharmacies that implemented medication synchronization saw more adherent patients.
Once patients go home, you won’t be there to remind them to take their medications. But you can use technology to help your patients stay adherent. For more tech-savvy patients, suggest they set alerts on their phones to remind them to take their medications. For others, consider stocking prescription bottles with timers in the caps. The timer resets to zero every time the bottle opens, so the display shows how long it has been since they last opened the bottle. This will help patients keep track of when they took their medication, which cuts down on the chance of missing a dose, or on multi-dosing.
Patients frequently leave their doctors’ offices confused or ill-informed about the medications prescribed. Without understanding the proper instructions, some patients will stop taking the medication when symptoms subside, instead of the recommended regimen. Others won’t understand the importance of the medication or severity of the consequences if they stop taking it. Without this information, patients will feel more lax about adherence. Make sure each patient understands what the mediation does and why it’s important before leaving the pharmacy. Clearing up their confusion can make all the difference.
If the cost of patients’ medications is too high, they might cut their pills in half or take them every other day. Patients in tight financial situations believe they’re stretching the prescription—and their dollar—for longer. If you notice a patient picking up a 30-day fill every 60 days, ask about their ability to afford their medication. If it’s keeping them from being adherent, work with their doctor to switch them to a generic equivalent, or to find coupons or financial assistance that can help them afford their medication.
Some patients will stop taking their medications because of the negative side effects they experience. Explaining the possible side effects when patients first fill the script will let them know what they can expect. Then, ask if they’re experiencing any problematic negative symptoms when they refill the prescription. If the side effects are making adherence difficult, work with their doctor to find a way to quell the symptoms, or to find a new prescription with fewer side effects.