Medication adherence is a complex issue without a silver bullet solution. At L.A. Care, we take a multi-pronged approach to this challenge by working collaboratively with our physicians, pharmacists and members.
So what can we do?
At L.A. Care, we believe the quickest way to success is to work in partnership with our members, physicians and pharmacists to provide needed support and education. Simple steps to help improve medication adherence are:
On initial prescription, the prescriber should take on the responsibility for educating the patient on the medication benefits and side effects
As part of follow-up, prescribers should allow time for patients to discuss their medication effects and concerns
“Keep it as simple as possible” – a simplified regimen helps the patient to comply
Promote patient aids such as medication fill boxes, calendars or cards that help the patient manage the medication regimen
Know the available patient education programs conducted by the medical groups and the health plans, such as medication therapy management (MTM), pharmacy case management, etc.
When appropriate, prescribe 90 day fills for chronic conditions
Patients with chronic conditions often become overwhelmed by the fact that they must take medication for the rest of their lives. Compounding the situation, there isn’t an immediate and noticeable impact when they discontinue taking their chronic disease medications. This lack of patient awareness hides the known consequences of non-adherence. For the patient, medication side effects can seem worse than the medicine’s benefits. It’s easy to understand why they don’t want to take something that might make them feel worse than the illness symptoms that are being treated. Finally, often there is a complicated multiple medication regimen that requires timing and coordination with other therapies and daily activities. Combined with multiple visits to the pharmacy and various prescribers, this leads many patients to non-compliance.
One physician challenge is the fragmented nature of our care system. Patients have multiple prescriptions which makes reconciliation of medication regimens challenging. Studies show that the average senior patient can have a minimum of nine prescriptions, with some patients having as many as 20. This doesn’t count self-prescribed over the counter and herbal remedy medications that many patients choose to take. Again, a continuous challenge is to coordinate what can often be a complex regimen.
With increasing demands on physician time and increasing patients with multiple chronic conditions, the patient education around the medication regimen can be left to other health care professionals in disease management, case management, and pharmacy. The challenge for primary care physicians is to ensure this education is coordinated and timely.
Access to real time data at the point of service remains a significant issue. Awareness and management of the medication data is key to making sure that medication regimens are not only appropriate but safe. Integration of the medication data and necessary lab data into care plans has been shown to improve the probability of improved clinical outcomes. The ultimate goal is to have the integration of physical health data, medication data, lab data, and behavioral health data in a data management system that allows access to all stakeholders, including the patient, in one easy to use system.
For medication adherence resources to share with your patients, please download the Taking Medicine flyer available in the resources section of this page.