5 Pharmacy Services to Improve Medication Adherence

My dad retired a few years ago from family medicine and I remember hearing his stories about medications. “Blood pressure medicine? I finished those last week doc.” What medicine are you out of? “The pink one, shaped like a football.” (To which he said “no not the pharmacist, I mean what does the pill look like!”)

The truth is, only about half of patients with chronic diseases take their medications as prescribed and medication non-adherence is estimated to cost the healthcare system over $300 billion annually in avoidable expenses.

How can you help your patients stay adherent? Let us do the work! Take a look at these pharmacy services that can improve adherence, and I’ll bet you’ll find at least 1 or 2 that can help your patients.

#1: MedAvail Pharmacy Kiosks

Why not bring the pharmacy right to your office? The MedAvail kiosk at the health system I work for holds up to 550 bottles of medications; we are putting ours in a cardiology clinic and it will contain nearly everything the office would write for. A pharmacist and/or pharmacy technician is operating the kiosk at all times, so pharmacists can still bill insurance, counsel patients, check for drug interactions, and everything else we would otherwise do.

In addition, MedAvail operates its own call center and so there is the option to contract the operation of the kiosk out with them. The primary limitation, at least at this time, is that controlled substances are not allowed to be put in the kiosk. State law also still varies considerably on whether or not the kiosks are allowed and the conditions under which they can be implemented.

#2: MedsOnCue

Patients will often discard the paper medication information leaflets that accompany a prescription medication. MedsOnCue has received approval in numerous states for pharmacies to opt-in patients to receive only the QR code in place of leaflets. There is also an inpatient version, where discharge medication counseling videos can be queued up on a tablet PC and the patient can listen to them prior to going home.

While of course nothing is better than interaction with a healthcare provider, the videos certainly beat the tiny-print, hard-to-read leaflets from the pharmacy or the convoluted discharge medication instructions generated by hospital EMRs.

MedsOnCue also has 3 customizable services designed to reinforce patient relationships and enhance patient safety:

• Connect Me: Click-to-call access to client-designated pharmacies or healthcare organizations call centers

• Remind Me: Streamlined registration with the pharmacy’s or healthcare organization’s medication alert and reminder program

• Inform Me: On-demand access to additional prescription information and health/wellness resources

#3: Medication Synchronization

Medication synchronization, or “med sync,” is a service that many independent pharmacies, and even chains, now offer that times a patient’s prescriptions to all fill on the same day. For healthcare professionals in the clinic, med sync in the long run can save time on refilling prescriptions. Once the pharmacy synchronizes all a patient’s medications, we can work with prescribers to request all the refills at one time, avoiding numerous requests for the same patient trickling in over the course of a month or more.

For the pharmacy, it saves a lot of time: 

• On the phone with patients requesting refills

• Putting back medications they never pick up

• Ringing them up at the register

A study conducted for the National Community Pharmacists Association of >8000 patients found that patients on med sync were 2.5 times more likely to stay adherent and 21% less likely to discontinue drug therapy. In 2017, there were 3.5 million patients participating in the service, up from 355 000 in 2014. 

Patients can learn more about the service on this informational site from the APhA Foundation.

#4: Blister Packaging

Image: ©Sprinno/Wikimedia Commons/CC-BY-SA-3.0

Blister packs have been around for a long time in both the inpatient and long-term care settings, but did you know many community pharmacies also offer them? Blister packs can be a great way to get your patients with complex medication regimens set up for success by allowing all of their medications for each day and time to be packed in each blister. 

These are offered by many independent pharmacies because they are easy to get started with - most wholesalers carry the blister packs and it only takes a minimal amount of extra equipment. Of note, these packages are not child-resistant. While we will obtain consent from the patient, it is of course not a great option for families with young children in the home.

#5: Medication Envelopes

An alternative to blister packing is the use of individual envelopes for each dose; an alternative PillPack made famous. Individual envelopes have actually been around the inpatient setting for a long time, and I would bet there are still inpatient pharmacies that package some doses using a machine similar to the one used for these packs. 

As with blister packs, it is critical to communicate medication regimen changes to both the patient and pharmacy when using envelopes because: 

• Medication will still be in their existing doses at home.

• If the pharmacy is unaware of the change, we will dispense it again in the next package of medication.

NOTE: Like blister packs, the envelopes are also NOT child-resistant. 

Alex Evans is a community pharmacist located in Jacksonville, FL, and founder of PharmCompliance.com, a site dedicated to demystifying pharmacy compliance and optimizing operations to help community pharmacies thrive.

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