Last year a New York Times article referred to the high incidence of medication non-adherence as “an out of control epidemic,” and noted as many as 30 percent of all prescribed medications either go unfilled, or unused. The article cited “staggering statistics,” including an estimated $290 billion in added health care costs, and as many as 125,000 deaths each year that might be avoided with a proper medication regime.
Pharmacists have long understood their unique position in helping to combat non-adherence. As the professionals who not only dispense medications, but are the last point of contact with patients, pharmacists can help educate patients about prescriptions, track usage, and also expedite the refill process.
In attempting to better understand the causes of non-adherence, research by CVS Health drew several important conclusions:
- Patients who take multiple medications often make numerous trips to the pharmacy each month for refills, which can make it harder to keep track of medications.
- Patients are responsive to electronic refill and adherence reminders.
- Patient histories can be an important indicator as to likelihood of becoming non-adherent.
Taken in isolation, each of these conclusions reveals a different facet of the complex reasons for non-adherence. But for pharmacies that have invested in comprehensive technology systems, it is possible to take an “all of the above” approach, and launch a full-out assault on improving patient adherence.
Specifically, a well-designed technology solution will include a refill sync module that, if properly and fully utilized, can help address key issues at both the pharmacy and patient levels:
Key benefits of a refill management system will include:
- Creation of workflow schedules that automatically plan daily refill workload, and allow multiple prescription refills for a single patient on the same day.
- Inventory management, whereby appropriate medicine levels are maintained, with quantities automatically deducted based on programmed refills. This capability allows pharmacists a better understanding of medication requirements, and minimizes need to maintain inventories of expensive drugs that may sit unused on the shelf.
- Useful analysis of patient data. Pharmacists capture a trove of information about patients — everything from personal health histories to past prescription medications to demographic information. Until recently, that information has largely gone unused. But now, thanks to the power of technology, pharmacists are increasingly relying on data analysis to better understand their patients, and assess the likelihood of adherence.
- Ability to create individualized medication synchronization programs for patients. This involves coordination of all medications so a patient can pick up all prescriptions at the same time, on a pre-determined day. 2018 research published in Health Affairs found patients whose medications were synchronized were up to three times more adherent, and had a nine percent lower rate of hospitalization.
- Ability to generate automatic reminder texts or emails to alert patients when a refill is required. Subsequent reminders can be sent if a filled prescription remains in the bin.
- Potential for increased sales, as patients with a clear understanding of their medication regime are more likely to purchase — and use — prescribed medications.
- Capturing patient data allows the pharmacist a “bird’s eye view” of a patient’s prescription drug history, which can help identify patients who would most benefit from direct intervention, including a synchronized medication plan.
- Help improve CMS star rating. The Centers for Medicare and Medicaid Services (CMS) developed the “Five Star Quality Rating System” as a way to assess performance of each Medicare health care plan. According to industry trade association American Pharmacies, health plans are rated on multiple measures, including five specifically related to medication management: High-risk medications, diabetes treatment, medication adherence for diabetes, adherence for hypertension, and adherence for cholesterol. These five measures account for almost half of a health plan’s score.
- Although CMS does not issue Star Ratings directly to pharmacies, each plan regularly assesses the performance of each pharmacy in its network, and assigns star ratings, primarily by reviewing claims. A technology-based adherence plan can boost a pharmacy’s performance.
Clearly, a fully-implemented prescription synchronization module offers tremendous benefits both to pharmacy management and patient care. But, a pharmacy manager must be careful to choose a technology solution that offers the capabilities that best address each pharmacy’s unique needs. Many synchronization modules have come to market in recent years, with varying degrees of capability.
- Seamless integration of data across all system modules.
- Skip logic capability so that patients are guided through an appropriate pathway of questions, based on answers to initial questions. This allows the pharmacist to capture a more customized assessment of patient histories.
- Scheduling functionality that allows for a daily queue of required refills.
- Ability to program outbound calls, emails and text messages to notify patients regarding refill and dosage alerts, and pickup notifications.
Integration with dispensing data as a way to assess medication adherence.
- Reporting functionality that allows customized reporting. As noted by Specialty Pharmacy Times, the system must be designed to support clinical, plan and manufacturer level reporting requirements. This is critical, since assessment data will often be used to support outcomes reporting.
- Adherence red flag alerts in which patients at risk of non-adherence are immediately identified.
- Record and storage functionality so that entered data can easily be recorded, stored, and accessed.
Inventory integration, whereby a pharmacy’s medication supplies are continually synced to ensure required medications are in stock when needed.
For more information about PrimeRx™ and its automated refill management system, please visit www.MicroMerchantSystems.com.
One popular option is the PrimeRx™ pharmacy technology solution offered by Micro Merchant Systems. Among its extensive capabilities, PrimeRx™ includes an advanced automated refill management system that provides all of the capabilities identified above. Pharmacists nationwide are using PrimeRx™ to improve pharmacy workflow and gain insight into patient prescription histories. Armed with this comprehensive, real-time information, pharmacists have never had a better tool to help in the ongoing war against non-adherence.