Pharmacists and Adherence

Adherence: Pharmacists Helping Patients Take Their Medication as Prescribed

Medication adherence refers to whether a patient is taking their medication(s) as directed by their physician.

It is estimated that non-adherence to a medication regimen costs the healthcare system as much as $290 billion per year due to the need for patients to seek out costlier treatments such as hospitalization or emergency room visits for their condition which could have been prevented if they properly took their medication.

In fact, studies have shown that medication misuse is a significant cause of hospital readmissions and can be prevented in nearly two-thirds of all cases. Patients on complex drug regimens taking multiple prescriptions are at high risk for non-adherence.

Ten percent of cardiovascular patients make 11 or more pharmacy visits in 90 days, and have 23 or more prescriptions. To put this in perspective, the average number of retail prescriptions per capita was 12.6 in 2009.

As former surgeon general C. Everett Koop said "Drugs don't work in patients who don't take them." And independent community pharmacists play a key role in ensuring a patient properly uses their medication.

  • A retrospective analysis of data published over 40 years found that in-store face-to-face counseling was the most effective at driving patient adherence followed by nurses talking directly with patients as they were leaving the hospital1
  • Face-to-face counseling by a pharmacist is 2 to 3 times more effective at increasing patient adherence.2 This is due to the fact that independent community pharmacists are readily available as a resource to patients and can identify potential harmful drug interactions when a patient is prescribed multiple medications. These multiple prescription regimens have the added effect of complicating patient adherence, particularly if the refill dates for each prescription are different.
  • Patient behavior indicates that certain patients prefer to access prescription medications via mail service and others through community pharmacy channels3
  • Restrictive benefit designs that incentivize patients to use less preferable pharmacy channels may adversely affect patient convenience, which could have the unintended consequence of reducing medication use and adherence.4
  • Fifty-eight percent of employers are using retail pharmacies to dispense 90-day supplies of medications,5 there is no need for any health plan sponsors to implement a mandatory mail plan design.

To further assist pharmacists in their work to maintain patient adherence, NCPA has launched the Simplify My Meds program for its independent community pharmacy members. The innovative adherence program provides pharmacists with the tools to help coordinate patients' prescription refills to a single day of the month among other resources.