There have been more than 40,000 articles published on medication adherence (or lack thereof) since the 1960s, but not a lot to show for it in terms of improving health outcomes. Research across those 40-plus years has consistently demonstrated that adherence to medications, regardless of the diagnosis or health condition, is poor. So where do we go from here and what impact can community pharmacists have? The answer is: plenty. You are probably aware, but in case you didn’t know, the most effective communicator about medication adherence is you, the pharmacist.
Perhaps it’s time we change our perspective and approach to non-adherence. We (not just pharmacists, but other health care providers as well) are often quick to conclude that because a patient’s condition is not well-managed, it must be a sign that their medications are not effective. But is it really necessary to increase the dose or add another agent because a patient is not at goal for their hemoglobin A1C or LDL? Do we ever stop to consider that non-adherence could be the culprit? As community pharmacists, we need to “normalize” non-adherence and integrate it into our routine patient assessment and counseling. Just as you always take the time to review duplicate therapies, drug-drug interactions, and identify cost-effective alternatives, regularly assessing adherence and addressing potential barriers can help improve your patients’ health outcomes.
You’re probably thinking, that all sounds good, but I have no clue how to predict non-adherence in my patients. Fortunately, there is a tool that can help you do just that. It’s called the Adherence Estimator®, and it’s designed to quickly assess the likelihood (low, medium, or high risk) of a patient remaining adherent to a newly-prescribed medication. It has taken some of the most common barriers to adherence and classified them into three essential health beliefs: commitment, concern, and cost. The user-friendly tool is evidence-based and backed by research, but it’s also practical enough to be easily scored and interpreted. It only takes about a minute to administer (which is why it’s featured in this column), can fit into your workflow, and serves as a great conversation starter when you’re counseling on a new medication.
After the patient answers three short questions about his/her beliefs about the medicine, the Adherence Estimator® scores the patient’s responses and provides easy-to-understand, personalized information that addresses the patient’s specific concern(s) about taking that medication.
You can learn more and use the online version of the Adherence Estimator® at www.merckengage.com/rxforhealth.
As we’ve shared before in this column, NCPA remains committed to the notion that as one of its most critical functions, community pharmacists educate patients on the importance of taking their medications as prescribed. The Adherence Estimator® can serve as another tool that pharmacists have in their arsenal to improve medication adherence and the well-being of their patients.
Reprinted with permission from National Community Pharmacists Association in the June 2012 issue of America’s Pharmacist. For more information about NCPA, visit www.ncpanet.org