Nathaniel M Rickles1, Gary J Young2, Judith A Hall3, Carey Noland4, Ayoung Kim5, Conner Peterson5, Mina Hong5, John Hale5. 1. Department of Pharmacy and Health Systems Sciences, Northeastern University, Boston, MA, USA. Electronic address: n.rickles@neu.edu. 2. Center for Health Policy and Healthcare Research, Northeastern University, Boston, MA, USA. 3. Department of Psychology, Northeastern University, Boston, MA, USA. 4. Department of Communication Studies, Northeastern University College of Arts, Media, and Design, Boston, MA, USA. 5. Department of Pharmacy and Health Systems Sciences, Northeastern University, Boston, MA, USA.
Abstract
OBJECTIVE: To describe the extent of pharmacy detection and monitoring of medication non-adherence, and solutions offered to improve adherence. METHODS: Participants were 60 residents of the Boston area who had a generic chronic medication with 30 day supplies from their usual pharmacy. Participants received a duplicate prescription which they filled at a different pharmacy. For 5 months, participants alternated between the two pharmacies, creating gaps in their refill records at both pharmacies but no gaps in their medication adherence. Participants followed a scripted protocol and after each pharmacy visit reported their own and the pharmacy staff's behavior. RESULTS: Across 78 unique community pharmacies and 260 pharmacy visits, pharmacies were inconsistent and inadequate in asking if participants had questions, discussing the importance of adherence, providing adequate consultations with new medication, and detecting and intervening on non-adherence. Insurers rarely contacted the participants about adherence concerns. CONCLUSION: There is a need for more structured intervention systems to ensure pharmacists are consistently and adequately educating patients and detecting/managing potential medication non-adherence. PRACTICE IMPLICATIONS: The present study calls for more attention to building infrastructure in pharmacy practice that helps pharmacists more consistently identify, monitor, and intervene on medication adherence.
OBJECTIVE: To describe the extent of pharmacy detection and monitoring of medication non-adherence, and solutions offered to improve adherence. METHODS:Participants were 60 residents of the Boston area who had a generic chronic medication with 30 day supplies from their usual pharmacy. Participants received a duplicate prescription which they filled at a different pharmacy. For 5 months, participants alternated between the two pharmacies, creating gaps in their refill records at both pharmacies but no gaps in their medication adherence. Participants followed a scripted protocol and after each pharmacy visit reported their own and the pharmacy staff's behavior. RESULTS: Across 78 unique community pharmacies and 260 pharmacy visits, pharmacies were inconsistent and inadequate in asking if participants had questions, discussing the importance of adherence, providing adequate consultations with new medication, and detecting and intervening on non-adherence. Insurers rarely contacted the participants about adherence concerns. CONCLUSION: There is a need for more structured intervention systems to ensure pharmacists are consistently and adequately educating patients and detecting/managing potential medication non-adherence. PRACTICE IMPLICATIONS: The present study calls for more attention to building infrastructure in pharmacy practice that helps pharmacists more consistently identify, monitor, and intervene on medication adherence.