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A recent study of patients with multiple sclerosis (MS) who used online tools to manage their prescriptions revealed similar adherence as those who engaged telephonically. The retrospective study was conducted by AllianceRx Walgreens Prime, one of the largest specialty and home delivery pharmacies in the U.S.
AllianceRx Walgreens Prime launched its digital service offering in late 2019 as a response to patients wanting the ability to self-service the refilling of their specialty medications while maintaining the pharmacy's high level of patient support for managing complex or rare disease conditions. After securely logging into their account, patients select their specialty medicine(s) to refill, and answer both operational and clinically-focused questions specific to their condition. Proprietary algorithms use the patient-reported responses to identify patients who require additional support from pharmacists, who then consult with the patient. At any time, patients may request to speak with a pharmacist. Today, in addition to MS, digital clinical assessments are available for patients with chronic inflammatory disease, cystic fibrosis, idiopathic pulmonary fibrosis, organ transplants, lipid and blood disorders, and cancer.
Sabeen Hasni, RPh, director of pharmacy quality at AllianceRx Walgreens Prime and a lead researcher of the study, said the research team wanted to gauge the impact of digital clinical assessments on outcomes and the patient experience. "The hypothesis we tested in this study was that digital utilization should not negatively impact adherence or patient experience, as measured by proportion of days covered (PDC) and other factors such as select survey questions and patient feedback," she said. "We are helping to make managing care a more accessible and convenient path to better health. Adherence is one measure we are analyzing."
Hasni said patients who are therapy compliant generally have fewer disease exacerbations, thus leading to reduced cost and burden on the healthcare system, and have improved therapy outcomes. "Adherence is also used in the healthcare industry, by payers and accreditation bodies, to gauge the quality of care provided by pharmacies. This is why we chose PDC as a key indicator of the clinical impact of patients' use of digital clinical tools," she said.
During the study, researchers focused on nearly 28,000 patients with MS and select medications used to treat MS, over a two-year period between July 2019 and June 2021. They analyzed data pulled from the company's prescription-processing platforms as well as digital service logs. Initial observations indicated that over the two-year period, patient engagement with digital channels increased by 17% within the MS population over time. Hasni said adherence, as measured by PDC, was statistically higher across almost all MS therapies included in the study.
Hasni said next steps include using the results internally to continue to improve the patient experience and increase patient utilization of digital where appropriate.
"We know that not all patients have the same clinical needs," she said. "Some require a high-touch experience, and some can self-serve, requiring minimal human interaction in most cases. With the digital option, we are tailoring our programs to meet the patient's preference and clinical needs, while ensuring that if certain criteria are met, intervention protocols will require the patient to engage with our staff so that clinical outcomes are not negatively impacted."
Miller added that the team anticipates sharing the data with pharmaceutical manufacturer partners and payers to demonstrate how use of digital adds value by promoting adherence, improving patient satisfaction and reducing prescription processing turnaround time.