- Patients who receive mail-order medications are notably more likely to avoid medication non-adherence compared to those who receive their prescriptions from a traditional pharmacy, according to research presented at the American Stroke Association’s International Stroke Conference 2016.
Using data from Kaiser Permanente, researchers concluded that patients picking up prescriptions from traditional pharmacies were adherent only 47 percent of the time, while those receiving medications from mail orders were adherent 74 percent of the time.
The numbers stayed consistent when researchers broke the data down by medication type.
With regard to those taking cholesterol-reducing statins, those receiving medications from pharmacies were adherent 56.4 percent of the time, and those receiving mail orders were adherent 88 percent of the time.
Those taking anticoagulants saw similar results, although less stratified. Those receiving prescriptions from a pharmacy were adherent 45 percent of the time, and those receiving mail order medications were adherent 56 percent of the time.
The price of medication non-adherence
Medication non-adherence is a notable problem facing population health management, costing nearly $337 billion in 2013 alone. Other studies have indicated that medication non-adherence, and the adverse events and hospital readmissions that may result from it, can lead to $8 million in yearly costs per 100,000 patients.
Putting aside the financial burden medication non-adherence presents to providers, there is also a price to pay when it comes to chronic disease and population health management. When patients do not participate in their treatment plans, they run the risk of falling ill again – often more sick than they initially were – and being readmitted into the hospital once more.
Preventing and detecting medication non-adherence
Due to the critical effects medication non-adherence has on population health management, chronic disease management, and healthcare finances, creating adequate prevention and detection strategies are an integral part in creating a comprehensive wellness program.
Research claims that detecting medication non-adherence is an easier process than often let on. In a study conducted by CVS Pharmacy/Caremark and Brigham and Women’s Hospital, experts found that prescription filling habits are a key indicator of whether or not a patient will actually take their medications.
By examining a group pf Medicare Part D patients taking statin initiators, the research team found that those who went to the pharmacy to fill their prescriptions were notably more likely to then take them. Those who were diligent in refilling the prescriptions were also more likely to avoid medication non-adherence.
“In this cohort of Medicare beneficiaries initiating treatment with statins, we found that initial adherence during the first few months after initiation strongly predicted the 12-month adherence trajectory. Prediction was best when predicting consistent medication use and consistent nonuse,” the researcher team reported.
Other recent studies confirm these findings.
A study published in the American Journal of Managed Care explains that those who never make the trip to the pharmacy – primary non-adherents – pose a significant challenge to healthcare providers. Because providers have never before been able to collect data on patients who don’t actually fill prescriptions, providers haven’t been able to find these primary non-adherents.
However, EHR technology and e-prescribing is changing all of that.
“The recent adoption of electronic-prescribing (e-prescribing) systems has made prescription fill information increasingly available to providers within their native electronic health record (EHR),” the research team explained. “This access to aggregated, multi-payer pharmacy data creates an opportunity to identify and address primary nonadherence in clinical practice, possibly even in real time.”
Going forward, providers will need to explore all avenues – including predictive analytics as well as primary medication non-adherence – in order to determine who is most at risk of not taking their medications. In doing so, providers can help improve chronic disease and population health management.