WASHINGTON — Researchers from CVS Caremark Corp., Harvard University, and Brigham and Women’s Hospital have served up recommendations for how to promote medication adherence and improve the delivery of pharmacy care.
CVS Caremark said the research collaboration, formed in the fall of 2009, showcased its findings Thursday in a forum at the National Press Club in Washington, D.C., marking the halfway point of their three-year-initiative.
The research team leaders also called on regulators and lawmakers to sharpen their focus on ensuring people take their prescriptions as directed by their doctors as a means to bolster the quality of care and cut costs for caring for the chronically ill. CVS Caremark reported that nationwide annual excess health care costs due to medication nonadherence have been estimated at up to $300 billion annually.
"When we began, we knew our research would expand the science of pharmacy care," stated Troy Brennan, executive vice president and chief medical officer at CVS Caremark, who heads the research effort. "The more we studied the topic, the more we realized that there are steps our industry can take today to improve the rates at which people take their medicines. This is important work because we know if we can improve medication adherence rates, we have a unique opportunity to improve the quality and lower the cost of health care."
Recommendations offered by the research team included the following:
• Developing tools through continued research that will allow pharmacists to predict and target patients at risk for nonadherence and prescription abandonment, which will enable pharmacists to intervene to improve their care.
• Utilizing a "pharmacy home" concept in which one health care professional works with the rest of the medical team to manage and synchronize a patient’s medication therapy.
• Improving pharmacist and health care provider communications with patients to enhance adherence through individualized counseling.
• Researching the use of financial or other incentives to encourage adherence because immediate, positive reinforcement for the right behavior can be a powerful motivator to change behavior.
• Developing a personalized medication approach, such as through pharmacogenomics or individualized counseling with pharmacists, to best deliver pharmacy care.
• Studying social networks and connections to see how they can be leverage to improve medication use by individuals seeking help and advice from family and friends.
"Not surprisingly, we learned there is no single answer to solving the puzzle of adherence, even though this problem has been recognized for decades," commented William Shrank, M.D., who heads the research project for Brigham and Women’s Hospital and Harvard Medical School. "But there are practices we can improve upon and programs we can implement that can have an impact. That work can start today."
What’s more, researchers noted that there are policy initiatives the industry and Congress can promote to make sure people are aware of the importance of taking their medicines as instructed. Those proposals, according to CVS Caremark, include making the goal of improving medication adherence a national priority and encouraging legislative policies to promote education and incent provider and patient behavior; leveraging investments in innovative technology to simplify adherence; and supporting continued public/private partnerships to remove cost barriers and undesirable patient behavior.
