ARLINGTON, Va. — A new white paper highlights a lingering issue in the pharmacy arena: first-time prescriptions left on the shelf, known as abandoned prescriptions, the National Association Chain Drug Stores reported.
NACDS said the Network for Excellence in Health Innovation (NEHI) paper, "Ready for Pickup: Reducing Primary Medication Nonadherence: A New Prescription for Health Care Improvement," outlines the problem of prescriptions for newly initiated therapy that aren’t picked up and, in turn, never taken. NEHI noted that U.S. health care system must address this problem if national goals for improved health and reduced costs of medical care will be realized.
The rate of primary nonadherence (PMN), or the percentage of first-time prescriptions abandoned by patients, can climb as high as 30% among some classes of medication, according to recent research.
"In recent years, our health care system has begun to take action to improve patient medication adherence, yet primary medication nonadherence — the failure to commence newly initiated therapy — remains a major but largely unacknowledged problem," stated whitepaper author Tom Hubbard, vice president of policy research at Cambridge, Mass.-based NEHI. "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."
In May, a working group convened by the NACDS Foundation, the Pharmacy Quality Alliance (PQA) and NEHI framed the issues cited in the white paper. The report addresses key issues in the adoption and use of PMN, a new pharmacy quality metric on primary medication nonadherence endorsed by PQA in November 2013. Before e-prescribing, tracking PMN rates wasn’t feasible.
"The PQA PMN measure introduces a consensus-based, scientifically tested, nationally endorsed metric to the market," according to Laura Cranston, executive director of PQA. "This metric brings much-needed consistency in defining PMN, which will help us to identify, test and compare results for PMN interventions across health care settings."
The NEHI paper points out that current adherence policy focuses on patients who have received their therapies at least once, since these patients trigger payment claims processing that enables medication adherence to be tracked.
"This leaves out patients who never get their newly prescribed therapy at all," explained Hubbard. "Community pharmacies that receive e-prescriptions can now track primary medication nonadherence by comparing the e-prescriptions they receive to the records of the prescriptions that are actually picked up. This paper outlines the issues pharmacies face in using this data to create effective interventions with patients that will increase the first fill of new prescriptions."
NEHI makes eight recommendations to help stakeholders — from physicians and pharmacists to insurers and health plans — understand and address the problem, including pharmacist interventions with nonadherent patients. High on the list of recommendations is more dialogue among health care payers, the physician community and the pharmacy industry to establish common ground for action.
"Collaboration is key in the face of the challenges that result from patients not taking their medications as prescribed. And 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," commented Kathleen Jaeger, president of the NACDS Foundation. "We are pleased that NEHI has raised awareness of primary medication nonadherence, a critical public health gap."
