Overcoming challenges of patient adherence
Patient adherence is an ongoing challenge. There are so many medication options and response rates, it can be hard for a provider and patient to agree on the best course of action, let alone follow it. Other challenges include patient identification, remembering details, financial or physical barriers, effective communication and education, and transportation issues.
Patients can become non-adherent because of frustration or confusion with the dietary restrictions of medications. For example, when I counsel inpatients upon hospital discharge, one challenge I face is explaining a food-drug interaction between green leafy vegetables and Coumadin™ (Warfarin). Significant changes in consumption can inhibit anticoagulation effects that can lead to an irregular heartbeat that can cause a stroke, ultimately leading to death. Patients often interpret this to mean that they must avoid greens, but I re-iterate that they must keep “consistency” with their dietary intake of greens. The take home is to not over- or under- consume foods rich in vitamin K.
Not adhering can negatively affect clinical outcomes and cost. For example, a recent research study revealed commercially insured patients who were adherent to their oral diabetes medications experienced significantly fewer emergency room visits and inpatient hospitalizations. These same patients spent nearly $500 less on total healthcare costs compared to nonadherent patients, potentially avoiding more than $210 million in healthcare spending in 2016.
Tailoring care for improved adherence
I believe the key is to always remember that each patient is different, and we can’t use a one-size-fits-all model. As a pharmacist, I like to provide education through custom printed handouts, as well as talking directly to patients at the pharmacy counter or the bedside.
Taking a proactive approach with the adherence model can yield better results, instead of waiting for a negative patient outcome. The use of technology enables providers to streamline this approach, which is overall helping improve patient adherence and quality of life.
The use of a nonadherence risk assessment tool can help clinicians learn more about a patient’s specific requirements. Previously manual work – such as calling patients to remind them their medications are ready or of an upcoming appointment – is now more efficient with email, text and smartphone applications.
As a leading innovative company in health IT, Allscripts is consistently looking for advancements that make the complex medical experience easier, faster and less expensive. We work together with payers, pharmaceutical companies, medical providers and other organizations to help create technology that assists with patient adherence.
We currently offer RxInfo, eAuth, and eCoupon, all of which support medication adherence. RxInfo assists with patient education and fill reminders, while eAuth supports electronic prior authorization. eCoupon assists with the financial aspect of adherence creating financial savings. For information on these products please visit ClientConnect- Value Added Solutions for Your EHR.