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Combating Medication Non-Adherence Through Technology

February 17, 2020

It seems pretty straightforward: a physician prescribes medication, then the patient fills the prescription at a local pharmacy, and they take the medication as instructed.

Easy, right? Except when it's not.

For one thing, 20 to 30 percent of those prescriptions will never be filled with a pharmacist. Plus, as many as 30 percent will not be refilled when the time comes, and 50 percent of patients with chronic diseases will meet the American Medical Association's definition for medication non-adherence by taking under 80 percent of their prescribed medications.

The problem of medication non-adherence is severe – and worse – it’s costly. The Annals of Internal Medicine estimates that non-adherence causes nearly 125,000 deaths each year; 10 percent of all hospitalizations; and adds almost $300 billion in healthcare costs.

What is medication non-adherence?

Non-adherence comes in many forms, with the National Community Pharmacist Association citing behavior that includes:

  • Failure to fill or refill a prescription
  • Missed doses
  • Taking a lower or higher dose than prescribed
  • Discontinuing a medication early
  • Taking an old medication for a new problem, without a doctor's consent
  • Taking someone else's medication
  • Forgetting whether a dosage has been taken

Plus, there are many reasons why patients become non-adherent. The Kaiser Family Foundation found 30 percent of non-adherent adults cited cost as the main reason. Within that group, 19 percent never filled their prescriptions, 18 percent took an over-the-counter medication in place of the prescribed medication, and 12 percent cut pills in half or skipped doses.

Beyond cost, the AMA cites additional reasons for non-adherence, including:

  • Fear of potential side effects
  • Cost
  • Misunderstanding of the need for the medication
  • The nature of side effects
  • Time taken to see results
  • Having too many medications
  • Lack of symptoms
  • Fear of becoming dependent on drugs

Non-adherence is a major health crisis

Regardless of the reason, non-adherence has become a major health crisis in the United States. With so much at stake, you can bet that health professionals at all levels of patient care are actively engaged in helping patients understand the importance of taking their medications and finding ways to afford them. But pharmacists – the individuals often described as "the last line of defense" in engaging with patients – have an especially significant role.

After all, patients tend to see their pharmacists more often than their doctors. The Canadian Pharmacists Journal found that pharmacists see patients between 1.5 and 10 times more frequently than primary care physicians, due to the trust people have in the profession. Pharmacists are consistently at or near the top of Gallup's annual survey of most trusted professions. Doctors and nurses also earn consistently high marks.

Technology can help combat non-adherence

As pharmacists take on this challenge, they are increasingly turning to their pharmacy technology systems to help manage patient adherence efforts. Leading technology systems provide multiple pathways to allow pharmacists to identify patients at risk for non-adherence, proactively encourage and facilitate adherence and track patient outcomes.

Patient medication history

Tools can capture and store patient medical and prescription histories, which provides the pharmacist with immediate access to patient records. Ready access to this information can help a pharmacist identify patients who either are non-adherent, or are at risk of falling behind in their medications.

Alerts about conflicting medications

A pharmacist who accesses a patient’s history will also be able to quickly determine if any prescribed medications conflict with each other or put the patient at risk for serious side effects or adverse interactions. Depending on the severity of the conflict, a pharmacist can either contact a prescribing physician to ask for an alternative, or advise the patient about the risk of side effects.

Automatic reminders

Technology allows the pharmacy to automatically generate outbound text messages, emails and phone calls, to remind patients about renewals and pickups. These simple messages can have a tremendous impact in reminding patients that a prescription is about to run out, thereby helping to avoid a missed dosage, or even worse, a patient simply deciding to forego renewing a prescription. However, since only about half of the U.S. senior population own mobile phones, a pharmacy manager must not rely on automatic reminders as a sole solution.

Mobile apps

A number of pharmacy technology systems offer mobile apps to facilitate the prescription reorder process. Patients can easily submit refill requests and essentially have 24/7 access to their pharmacy. 

Electronic prescription processing

Surescripts reported that 85 percent of prescriptions are now transmitted electronically with essentially all pharmacies able to receive and process electronic prescriptions. This eliminates the need for a patient to physically visit a pharmacy for a prescription drop-off and the ensuing wait for it to be filled. Instead, an advanced technology system will seamlessly add the prescription to the pharmacy's "fill queue" and automatically alert the patient when the prescription is ready to pick up.

Medication synchronization programs

Pharmacists and their patients rely on synchronization programs as a one-stop pharmacy management solution. These programs essentially allow patients to schedule monthly meetings with their pharmacists, usually by accessing the pharmacy’s online scheduling service. During the visit, a patient will pick up that month’s supply of all medications and have the chance to speak one-on-one with the pharmacist about any concerns regarding those medications.

Faster prescription fill rates with fewer mistakes

Pharmacies increasingly rely on technology to fill prescriptions and manage drug inventory levels. These are two procedures that, when performed manually, are very time consuming and require a pharmacist’s full attention. But by relying on an automated system, the process becomes much faster and the risk for error is minimized. Automated processing frees up some of the pharmacist's time, which means more time can be spent interacting with patients, providing counsel, and answering questions patients may have about their medications.

Pharmacy discounts and manufacturer rebates

Pharmacists can help alleviate the costs of certain drugs by recommending generic versions, or by contacting a physician’s office to request a less costly alternative. A more efficient solution is sometimes available through manufacturer coupons, which a pharmacist may be able to offer at point-of-sale.

Conclusion

A somewhat famous quote within the medical community is a good way to conclude. When discussing the growing problem of medication non-adherence, Former Surgeon General C. Everett Koop stated: “Drugs don't work in patients who don't take them.” More recently, The New York Times referred to the problem as an "out of control epidemic."

But thanks to dedicated medical professionals, including the nation's pharmacists, who are armed with high-functioning technology systems – this is an epidemic that can be addressed and hopefully eradicated. 

Let technology assist in lessening medication non-adherence today. Find the right pharmacy management systems for your needs – only on G2. 

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