Retail pharmacies, including chains and independents, have made it easier for patients to fill prescriptions. In response to patients’ growing expectations of convenience, pharmacies have started appointment-based medication synchronization programs, 90-day fill programs and mail-order delivery services.
By meeting these new expectations, pharmacies hope increased convenience will translate into increased medication adherence, prescription revenue and other revenue linked to their clinical performance.
Reducing pharmacist-patient facetime may decrease some patients’ adherence
An unintended consequence of making it more convenient for patients to get their medications may be increased nonadherence by some customers. Consumer-driven amenities like med sync, 90-days fill and home delivery can decrease patient visits to the pharmacy and reduce face-to-face conversations between patients and pharmacists.
Without those in-person consultations, some patients might be less likely to take their medications as prescribed, because they’re unable to overcome the barriers to adherence. These barriers may include cost, transportation, side effects, concerns about clinical value and effectiveness, proper usage and more. This subgroup of patients relies on personal interactions with pharmacists and pharmacy staff to overcome those barriers.
The challenge for retail pharmacies, then, is to make prescription fills more convenient for all patients without making medication adherence more difficult for some.
Four key steps to targeting patients at risk for nonadherence
The answer to the challenge, according to McKesson retail pharmacy experts, is using technology to identify patients at risk for nonadherence. Retail pharmacies can use data-driven insights to craft personalized clinical programs that mitigate the risk. Then, this subgroup of customers can take full advantage of the pharmacy’s other convenience-based prescription fill and refill programs.
McKesson pharmacy experts outlined the four key steps involved:
1. Select disease states most appropriate for the pharmacy
Pharmacies that want to stop nonadherence before it happens should choose the chronic medical conditions they want to target. They should use their pharmacy management systems to identify prescription drug categories that offer the most opportunity for both medication adherence improvement and revenue opportunities. For most pharmacies, the likely choices would be diabetes, hypertension and cholesterol. Medicare uses adherence scores in those three medication categories to determine the star ratings of Medicare Advantage plans that offer prescription drug benefits to beneficiaries.
2. Define adherence ranges for targeted medications
Most pharmacies define adherence as the percentage, or proportion, of days covered by a prescription drug. A patient with a supply of medication that covers 80 percent of the time he or she is prescribed to be on the medication is considered adherent. Moderately adherent patients typically have a 60 percent to 80 percent supply. Non-adherent patients often have less than a 60 percent supply.
3. Identify a manageable pool of moderately adherent patients
Pharmacies should use their pharmacy management systems to identify patients who are moderately adherent to their prescription medications. That means they have filled enough prescriptions over a specific time period—usually six to 12 months—to give them 60 percent to 80 percent of the medication they were prescribed to treat their diabetes, high blood pressure or high cholesterol. Using data from the pharmacy management systems, the patients’ medication histories and other sources, pharmacies should build medication profiles of each of the moderately adherent patients in a central database.
4. Develop and execute individual patient adherence action plans
By using and integrating various technologies, pharmacies should have complete, real-time profiles of each moderately adherent patient. Profiles should include medication histories, drug needs, usage and adherence behaviors. With actionable information at their fingertips, pharmacists can track adherence levels and create clinical programs to address individual patients’ medication needs and conditions.
The goal of this approach is to identify a subgroup of pharmacy customers whose medication adherence can be quickly improved by counseling and other interventions before nonadherence becomes an issue.
Clinical improvements can drive operational performance at pharmacies
Having detailed information about patients’ medication behaviors easily available via integrated technologies allows retail pharmacies to improve patient care, as well as make cost-saving operational improvements.
- Pharmacies can focus on patients who truly need additional counseling, a change in delivery methods or a change in therapy, rather than repeatedly contacting customers who are temporarily non-adherent because they changed pharmacies for personal reasons.
- Pharmacists can focus on interactions that are likely to succeed, rather than spend resources counseling patients who aren’t likely to discuss a change in therapy due to apathy or skepticism about the effectiveness of certain drugs.
- Patients can have more consistent contact with medication experts who know their medication and medical history. Because clinical activities are already organized, and specific data about a patient’s particular situation is readily available, pharmacists can improve outcomes in a single interaction.
- Instead of workflow focused on answering phone calls, contacting physicians and filling prescription orders, pharmacists can use their top-of-license skills to conduct comprehensive medication reviews, provide medication therapy management services and consult with the patient-care team about customers’ medications.
- Improved efficiencies mean that pharmacies can incorporate high-touch patient services such as behavioral coaching, medication reconciliation and medication synchronization into their face-to face meetings with patients, maximizing every consultation.
By using integrated technologies to identify patients at risk for medication nonadherence, retail chain and independent pharmacies can create customized clinical programs to reduce that risk, promoting better health for their patients and better business health for themselves.
Related: Learn more about McKesson’s medication adherence and clinical performance tools and technologies for retail pharmacies