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The Network for Excellence in Health Innovation (NEHI) has issued a report that sheds new light on the issue of patients’ failure to comply with prescription drug regimens. “Ready for Pick Up: Reducing Primary Medication Non-Adherence — A New Prescription for Health Care Improvement” examines a previously murky aspect of the problem: newly prescribed drugs that are never picked up by the people they are intended to help.
The research, which grew out of a working group assembled in 2014 by the National Association of Chain Drug Stores Foundation, the Pharmacy Quality Alliance (PQA) and NEHI, concludes that, in some therapeutic categories, up to 30% of scripts that have been filled and are waiting at the pharmacy are abandoned.
Patients who, for whatever reason, don’t take the medication prescribed by their doctor often see their condition deteriorate and require more extensive and costly treatment than they otherwise would have.
“In recent years our health care system has begun to take action to improve medication adherence, and yet primary medication nonadherence — the failure to commence newly initiated therapy — remains a major but largely unacknowledged problem,” says NEHI vice president of policy research Tom Hubbard, who wrote the report. “The good news is that potential strategies for reducing primary medication nonadherence are emerging as electronic prescribing becomes common. This paper is a call to accelerate action that will reduce the failure to pick up newly initiated medication therapy.”
The report includes eight recommendations for work on implementation of the new primary nonadherence metric, which leverages data generated by electronic prescribing, that won the backing of PQA a year ago. Close interaction among health care stakeholders, including insurers, plan sponsors and benefits purchasers, is essential to help bring about improved patient outcomes, cost containment and effective strategies for population health management. Retail pharmacy operators are encouraged to test different approaches to patient intervention, including experimentation with methods of communicating with nonadherent individuals and the development of best practices in the sequencing of outreach efforts to both patients and caregivers.
NEHI recognizes that pharmacies have to deal with major challenges in addressing the issue. “Community pharmacies face the same set of questions that confront all stakeholders … how much investment in new tools, new processes and new skills is necessary to achieve significant gains in adherence? And which patients, if any, should be targeted?”
The disadvantage that pharmacies have in not being part of the federal meaningful use program, which would make them eligible for financial incentives, is also noted, but the report concludes that primary nonadherence remains an opportunity for members of the profession as well as other providers.
“Collaboration is key in the face of the challenges that result from patients not taking their medications as prescribed. To that end, pharmacy works in close partnership with hospitals, physicians, nurses and other health care providers in helping patients understand the importance of taking their medications as prescribed,” says Kathleen Jaeger, president of the NACDS Foundation. “We are pleased that NEHI has raised awareness of primary medication nonadherence — a critical public health gap.”
The NEHI report deserves attention, as does the NACDS Foundation’s role in framing the discussion that helped bring it about. Under Jaeger’s leadership the foundation has sharpened its focus to concentrate on research, education and charitable activities directly related to primary objectives of the pharmacy profession. Its work in such areas as emerging health care models, transitions in care and rapid diagnostic testing, as well as nonadherence, is helping expand pharmacy’s scope and strengthening relationships with other providers.
Its recent track record clearly demonstrates that the NACDS Foundation is worthy of support, something industry participants can help provide at the organization’s upcoming annual dinner.
