Medication Adherence Best Practices | March 2021 | Clinical Corner

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Medication Adherence Best Practices

Adherence to prescribed medications is associated with improved clinical outcomes for chronic disease management and reduced mortality from chronic conditions. Conversely, nonadherence is associated with higher rates of hospital admissions, suboptimal health outcomes, increased morbidity and mortality, and increased health care costs. Approximately one in five new prescriptions are never filled, and among those filled, approximately 50% are taken incorrectly, particularly with regard to timing, dosage, frequency, and duration. Improving medication adherence is a public health priority and could reduce the economic and health burdens of many diseases and chronic conditions.1

  1. Use 90- day supply when appropriate to reduce number of refills needed per year
  2. Update prescription directions with the pharmacy- avoid verbal direction changes to patient only
    1. Update medication list with dosage changes.
    2. Include note on electronic prescriptions (e-RX) to cancel/close previous prescriptions (Rx’s) or contact pharmacy directly to update medications.
  3. Review medications for chronic conditions that were prescribed years ago
    1. Ask patient to bring medications to each visit.
    2. A proven cost-effective strategy to reducing unintentional nonadherence is the use of pillboxes and blister packs to organize medication regimens in clear and simple ways.
    3. Confirm patient is taking medication as prescribed, current directions may differ than original directions.
    4. Match-up refill request dates.
    5. Ask if patient is having trouble accessing or obtaining medications (cost issues, formulary coverage.
  4. Follow-up on newly prescribed medications
    1. Discuss short and long-term goals of medication.
  5. Address cost barriers
    1. Insurance plan discounts.
    2. Pharmaceutical company discount programs.
  6. Medication Adherence Questionnaire
  7. Screen for Depression as it can impact medication adherence.
  8. Focus on statin therapy for patients with diabetes and cardiovascular disease-
    1. The American Diabetes Association is now recommending that people with diabetes take a statin medication to decrease the chances of heart attacks and strokes, regardless of their cholesterol levels. The American College of Cardiology and the American Heart Association both say that statins can help prevent heart attacks and strokes and help lower the risk of getting heart disease.1
  9. Link to American College of Cardiology patient discussion resource

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1http://www.cdc.gov/mmwr/volumes/66/wr/mm6645a2.htm

2American Diabetes Association. New standards of care provide guidelines for statin use for people with diabetes to prevent heart disease. December 23, 2014.