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Patient Education, Communication Key for Medication Adherence

Patients say there is not enough time for patient education and communication about their prescriptions, hindering medication adherence.

Strong patient-provider communication, patient education, and lower costs can help patients more confidently manage and take their medications, according to a recent survey from DrFirst.

The survey of 200 patients without chronic conditions revealed that more than half of patients are not confident in managing their own drug regimens because they did not receive adequate patient education on the matter.

Providers who explain to patients how to take their medications – taking pills on a full or empty stomach, or at certain time intervals, for example – can increase medication adherence and drug safety in their patients.

But there is simply not enough time to do so, the survey revealed. Patients do not believe there is enough time for a face-to-face conversation about medication regimens, and they’d be right.

Instead, doctors are leveraging patient education tools to support safe medication use. But not all of those tools resonate with patients, the survey revealed.

Written educational tools, for example, are patients’ least preferred method to learn about their medications. Instead, patients would prefer a video link sent by their provider that outlines the drug protocol.

These results confirm prior knowledge about patient education and health coaching. These efforts are shown to improve medication adherence because they help patients understand the drugs they are taking, when they should take them, and why.

“Especially for people with chronic illness that are facing challenges like depression, or transportation, or complexity of medication regimens – that these interpersonal, trusted interactions with a nurse tend to be very effective,” said Peter Goldbach, MD, chief medical officer for Health Dialog, the population health management arm of Rite Aid Pharmacy, in a separate interview.

Goldbach and his colleagues at Health Dialog advocate for strong, interpersonal health coaching in the pharmacy, stating that it is essential for understanding patient barriers to medication adherence.

If, during a conversation, a pharmacist or nurse discovers a transportation barrier, they can enroll the patient in a drug delivery program. If the patient is experiencing financial woes, health coaches can work with the patient to find a generic alternative or rework the regiment to be more financially efficient.

What’s more, patient education can improve medication safety.

A 2016 ONC report outlined how providers engaging their patients during the drug prescription process can help identify prescribing errors. Specifically, providing patients with after-visit summaries, reviewing the summaries with patients, and utilizing patient teach back to outline a medication regimen are helpful strategies. These efforts will also ensure patients are taking their medications at the right dosage and follow other important protocol.

Costs are also getting in the way of medication adherence, the DrFirst survey revealed.

Three-quarters of patients have tried to obtain some sort of drug coupon or rebate to reduce their out-of-pocket spending. Patients do this by searching online or asking their doctors or pharmacists for financial help.

Sixty-four percent of respondents expressed interest in pre-paying their out-of-pocket costs if it meant they could receive a drug discount.

These results are consistent with previous findings about out-of-pocket costs and medication adherence. Numerous surveys have indicated that patients have anxiety about affording their medications.

A 2017 report from Consumer Reports Best Buy Drugs found that 14 percent of patients do not fill their prescriptions because of medication costs.

One-quarter of patients are paying more for their medications than they did one year ago. Seventy-four percent of those patients said that they received no prior warning of a drug price increase, and 24 percent say they likely will not be able to continue paying for their medications in the future.

As noted above, providers, health coaches, and pharmacists have some role to play in mitigating these cost issues. While the overarching pharmaceutical and payer industries have more control over the price tag of a certain medication and the amount the patient pays, providers can help patients identify workarounds that lower costs.

Directing patients to potential subsidies and rebate programs, helping them find less costly pharmacies, prescribing generics where possible, and designing drug regimens that are effective but less cost burdensome can help patients overcome the hurdles separating them from their medications.

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