Table of Contents
WOONSOCKET, R.I. — CVS Health has established a target to increase medication adherence by as much as 15%.
The latest Insights Report published by the CVS Health Research Institute, titled “Adherence: Why It’s So Hard and What We Can Do About It,” reviews key research findings on medication adherence and lays out its goal to raise adherence by 5% to 15% through new interventions by 2017.
For the past several years, the research institute has been focused on building the body of scientific knowledge related to medication adherence. Through various research collaborations, it has published or presented more than 50 adherence-focused papers in peer-reviewed journals and at clinical conferences. The report describes complex adherence challenges and actions that can make adherence easier and help lower overall health care costs.
“The reasons why people don’t take their medications for chronic conditions as prescribed by their health care provider are very personal and complex,” says CVS Health chief scientific officer William Shrank. “Over the past several years, CVS Health has invested in research to help the industry better understand medication nonadherence. Our goal now is to apply this knowledge and develop new interventions that will enable us to improve adherence for the patients we support.”
Key medication adherence research findings highlighted in the report include the following:
• Almost half of people taking a medication for a chronic disease stop doing so in the first year, with the biggest drop-off in the first month. Among patients on statin drugs, more than 50% stop taking their medicine in the first year.
• Forty-six percent of all patients don’t understand prescription dosing instructions.
• It has been estimated that up to a third of prescriptions written are never filled.
• Each additional dose that a patient must take in a day can reduce adherence by as much as 2%.
• Face-to-face counseling by a pharmacist is two to three times more effective at improving patient adherence than other interventions.
The report focuses on four key areas of CVS Health medication adherence research to date and cites programs and initiatives to address the identified issues.
The areas include how to reduce primary nonadherence, i.e. when patients do not pick up their first fill for a prescription. Pharmacist counseling and support can make a difference, notes the study, which details innovations implemented by CVS Health — such as its Pharmacy Advisor program — to foster counseling at its retail pharmacies. The report points out that the difficult work of adherence occurs in the home and outlines how best to support patients in their day-to-day medication regimens.
The role that pharmacy benefit plan designs play in supporting adherence is also examined, as is how strategic plan design can help reduce barriers such as cost, medication complexity and forgetfulness.
“We are actively piloting and testing a number of interventions to help make it easier for our patients to be more adherent,” adds Shrank. “For example, we know through our research that it is difficult for patients to be optimally adherent when they have numerous health care providers, take multiple medications with different dosing regimens, and make several trips a month to the pharmacy to pick up prescriptions.
“As a result, we are actively engaged in a variety of pilots to test prescription synchronization programs and innovative medication labeling and packaging.”
Despite CVS Health’s record of helping individuals to become medication adherent, the report concedes that meeting the 2017 objective won’t be easy. “All of this research, all of our interventions, all of our clearly tracked results have made one thing abundantly clear: Adherence is not simple,” the report says. “It’s a complex behavioral challenge, one that becomes exponentially more difficult for patients with multiple diagnoses, disabling illnesses or challenging life situations.”
