- Medication Synchronization Reveals Medication Adherence Barriers
For patients taking numerous medications, keeping track of those treatments can be tricky, often keeping those patients from achieving full medication adherence. As more patients are expected to be taking more medications, innovative adherence programs such as medication synchronization systems will be essential.
Medication synchronization is, in theory, a simple solution. The system aligns the prescription fill dates for all of an individual patient’s medications, reducing the likelihood that the patient will forget to fill that prescription.
Many med sync programs automate prescription fills and align multiple pills in bubble packs that help patients stay organized once they bring their pills home.
This strategy has proven effective in improving medication adherence rates. A January 2018 Health Affairs study found med sync increased medication adherence rates by 9 percent. This is a large proportion considering that health experts anticipate chronic care management patients to increase to 157 million by 2020.
At Graves Pharmacy, a regional pharmacy chain across Kansas, clinical leaders use medication synchronization to dial into a number of patient adherence barriers, according to Dared Price, Pharm.D, the President of Graves Drug Stores.
The pharmacy’s medication synchronization system of choice – Time My Meds from Omnicell – points out the patients who might need more help managing their medications. Patients are flagged because they have complex medication regimens or because they have a long history of poor medication adherence.
“This helps us focus on those people that we really need to talk to – not that everybody doesn’t need some help with being adherent,” Price said in an interview with PatientEngagementHIT.com. “But, it helps us focus on those particular patients that really need the help that are struggling with taking their medications.”
Price and his colleagues use those flags to discuss med sync options with patients at the point of service. When a patient comes in to fill and pick up her prescription, Price takes the opportunity to explain the benefits of medication synchronization and tries to create patient buy-in.
It’s not usually a hard sell, Price noted. Medication synchronization is a very simple and inexpensive strategy, and it helps patients just as much as it helps pharmacists and providers.
“A lot of patients don't know that pharmacies can do this for them,” Price said. “It seems like once we started asking people, it was almost a no-brainer for them. Absolutely they will sign onto medication synchronization. Us being able to follow through and not mess up in the medication synchronization process confirms to patients that they are going to get the right medication at the right time.”
Of course, this conversation still requires careful discussion with the patient. Although Price mentioned that he signs most of his patients up for medication synchronization during the point of medication purchase, he also ensures he discusses medication adherence strategies during medication management therapy sessions.
During these 30-minute to one-hour meetings with patients, Price works to uncover the barriers his patients face in remaining adherent to their medications. It is important for creating patient and pharmacist satisfaction to prevent these meetings from turning into a lecture. By focusing on barriers, Price avoids placing blame and instead identifies actionable advice.
“Nobody wants to get scolded and we don't want to scold anybody about not taking their medications correctly,” he stated. “We've found that in general terms, a lecture is not necessary. There’s usually always a reason for non-adherence whether it be a dose change, a side effect, or patient information. It’s not that the patient didn't think the medication was that important or something like that.”
“I've been surprised how easy it is to talk to patients about their adherence to the medication because it’s not always just, ‘oh, I forget,’” Price added. “It’s usually some reason that’s a solvable problem.”
Using medication synchronization programs has helped Price identify and remedy the challenges patients face when managing their treatments. For example, during program patient onboarding, Price noticed the extraordinary costs a single patient was paying for his numerous treatments.
The patient, who had been a patient of Price’s for a number of years, was taking about three different medications that in total cost him nearly $1,000 monthly, Price shared.
“I had never put it together that this was costing him all that much and that he was taking some things that could be easily substituted for something else,” Price recalled. “It wasn’t until we got him on a med sync program and I had the ability to sit down and look at everything that I saw these costs.”
The med sync program allowed Price to fill all medications at the same time, so the bill came up in full, highlighting the costs his patient was incurring. After making adjustments, Price lowered the patient’s bill to just about $100 a month. Price would not have been able to cost compare without insights from his med sync program.
Of course, there have been some barriers to implementing the medication synchronization program, Price shared. Although med sync seems like a simple solution, it in fact took him and his team a lengthy period of time to find the software that best meets their needs. This trial-and-error may be keeping other pharmacies from implementing the tool.
Price also encounters issues that stem from the doctor’s office, he said. These miscommunications make it essential that med sync programs include extensive patient-pharmacist communication lines.
“Patients start and stop medication all the time, and doctors change medications all the time,” Price pointed out. “The doctor’s office doesn’t always tell you that they do that. If you're not talking to that patient once a month as a part of a med sync program, then you're not going to know those things and it’s just going to be really difficult to get somebody synchronized.”
Price has embedded monthly conversations between his pharmacy and their patients to help support patient medication adherence. With each call, Price delves a little deeper with patients. What are your side effects? How are you paying for this? Are you getting your flu shot, or taking other seasonal health precautions?
This approach allows Price to maintain that patient as a customer and ensure he is on the right track for all of his medication needs.
Communication on the part of the pharmacy and doctor’s office is also key, Price stated. As a pharmacist, he is often left in the dark about a specific doctor’s medication adherence interventions, if the doctor uses any at all.
“I don't know that doctors really know about medication adherence,” he stated. “A patient might come in and say, ‘yeah, I've been taking my medication.’ The doctor might not necessarily know whether the patient actually has been taking the pill or not.”
The onus falls on the pharmacist to open up communication lines in these cases, Price explained.
“That’s where we can step up to the plate and say, ‘hey, doctor, I have this program that we can put this patient on. It will help track adherence and help this patient be adherent to the medication,’” Price offered. “That way doctors will have the information they need to be able to dose medications correctly.”
These meaningful conversations often end up being the difference between improving patient health and allowing individuals to fall through the cracks. Med sync programs serve as a helpful catalyst to drive these conversations, and supplement them in the long run.
But as healthcare professionals continue to address medication adherence issues, they need to foremost step up and communicate with patients.
“Sometimes it’s hard to ask somebody about adherence,” Price concluded. “Pharmacists don’t know whether patients want to be on the med sync program or not, or pharmacists don't think they have time to do that. But it’s entirely possible and worth it to get somebody on an adherence program because it just leads to so much more free time and patient success.”