GETTING PATIENTS TO TAKE THEIR MEDICINE on spec and on time is the challenge that never goes away—it's the deadweight baggage accompanying every industry innovation
since the arrival of aspirin a century ago. This month's feature on the "state-of-the-art" in medicines adherence strikes
a note of modest optimism that progress may be at hand, particularly as rapid advances in technology begin to remove some
of the barriers to communication that defy efforts to make patients more mindful of the connection between staying on treatment
and better health.
To keep the conversation going, Pharm Exec works closely with our sister conferencing organization, CBI, in celebrating best practices in adherence through its Strategic
Patient Adherence Awards program, given to worthy industry players each year at the CBI Patient Adherence & Support Summit
(PASS). The 12th Summit took place in April and, taking the position that success requires recognition, we want to single
out this year's winners, selected among dozens of applicants for their cutting-edge initiatives in the following four categories:
science, innovation, pharmacy and disease awareness.
Merck & Co. was recognized for excellence in advancing the science behind medication adherence. Led by retiring Merck outcomes executive
Colleen McHorney, the company has sponsored dozens of projects to uncover why people don't take their medications and to create
solutions. Merck's research has spawned a fresh consensus that time-honored demographics such as age, gender, race, education,
and income are not really significant in determining adherence. The main metrics driving non-adherence has been synthesized
for the industry in Merck's "Three Cs:" Commitment to the medication regimen; Concerns about side-effects, drug interactions,
and general safety; and Cost.
The Patient Performance Institute, an industry supported non-profit, received the award on innovation for its Patient Performance Enhancement Tool (PET), a self-assessment
to help patients understand where they are in their disease state at the point of discharge from the hospital. In its collaboration
with two hospitals in Maine, the PET pilot focused on acute cardiac and other high-risk inpatient settings, and was found
to have reduced total readmission rates by almost a quarter. By getting patients to think about their condition and address
factors such as their treatment history, financial concerns, social supports, and the role of caretakers and health literacy,
the PET tool helps clinicians ascertain why patients abandon drug treatment, allowing them to adjust care protocols and to
offer the right education and support.
MedVantx Inc.'s MedStart Connect Program also received an award for innovation in providing patients with a full month sample therapy even
before they leave a physician's office. As the first point-of-care formulary providing generics, OTC, and even brand therapies,
MedVantx specifically addresses primary stage adherence, where an estimated 40 percent of prescriptions written by doctors
go unfilled. After the patient leaves the office, MedStart Connect also provides telephone outreach services to encourage
prescription filling, as well as giving patients the opportunity to enroll in MedVantx's home delivery program, providing
the first "closed-loop" system—anticipating the patient's need at every step of the care journey—from the doctor's office
For its work to address barriers to adherence for diabetics across a wide network of pharmacies, McKesson won the award for disease awareness. Launched in 2008, McKesson's Pharmacy Intervention Program (PIP) has 3,000 participating
pharmacies that identify and coach patients with the help of pharmacists trained in motivational interviewing and health behavior
change techniques. Results from these five minute, face-to-face interviews yielded an average of four incremental refills
over 12 months per patient, improving adherence rates by 25 percent. Moreover, these patients remained compliant even after
the 18 month mark, evidencing a lasting health behavior change.
Walgreens, one of the largest drug chains in the world, received the PASS award for best pharmacy program. Also working with diabetes
patients, Walgreens partnered with a biopharmaceutical manufacturer to meet a critical care gap by providing an injection
training service. Its pharmacists have completed over 200,000 training sessions to date.
To learn more about these award-winning programs and to review what was discussed at the conference, please visit the CBI
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