Q&A: Resources for overcoming the adherence challenge

Winning the patient adherence battle is about aligning all stakeholders, from the patient to the pharmacist, to payers, employers, physicians and pharma, in a collaborative, patient-centered model that not only educates patients, but also actively engages them in managing their health and treatment regimens. To find out more about how McKesson is helping community pharmacists deliver better patient care through one-on-one interventions and coaching  — and get paid for it — DSN spoke Tuesday to Peggy Yelinek, VP and general manager of McKesson Patient Relationship Solutions.

DSN: What is the biggest challenge when it comes to getting patients to adhere to their medications?

Yelinek: The biggest challenge is identifying the unique adherence barriers each patient will face. Barriers may be anything from drug costs, to thinking it’s not important, to a lack of visible clues that reinforce the drug is working. What’s more, these barriers can change over time. For example, a patient with diabetes who is newly prescribed insulin may face denial, feel overwhelmed and feel like a failure because he or she didn’t succeed on oral medications — all of which can lead to nonadherence. An experienced insulin user may have other barriers, such as not testing blood-glucose levels or challenges with lifestyle management. This is a great example of why messaging for each patient needs to be tailored to their distinct needs in order to develop a comprehensive solution to help them overcome the barriers to taking their medications as prescribed.

DSN: Why is it so important that people take their medications as instructed?

Yelinek: While there are significant financial implications to medication nonadherence, perhaps the greatest concern is the impact on a patient’s quality of life. Medications simply do not work as effectively if not taken regularly, and skipping doses can have serious health consequences. With chronic conditions like diabetes, COPD or hypertension, taking your medications as prescribed could mean the difference between having a good versus a poor overall quality of life.  

DSN: What is the role of the pharmacist in addressing nonadherence?

Yelinek: We strongly feel that community pharmacists and their relationship with their patients are an integral part of the solution. Since pharmacists are knowledgeable, accessible and trusted by their patients, they are in a unique position to play a significant role in helping to control healthcare costs by offering patients convenient, cost-effective healthcare.  

McKesson’s Pharmacy Intervention Program, which expands patient access to one-on-one behavioral coaching from their retail pharmacists, is helping to achieve better patient care, enhance the role of the pharmacists and transition the pharmacy to a service-based business model. The Pharmacy Intervention Program found patients who received face-to-face behavioral coaching from their pharmacists showed significant adherence benefits. For example, COPD patients who received coaching showed an average of 1.6 incremental fills over 12 months, and patients coached in multiple diabetes programs showed an average of four incremental refills over 12 months when compared to patients who did not receive behavioral coaching.

DSN: How does McKesson facilitate delivering adherence programs to patients?

Yelinek: Supporting patients and driving their loyalty to their community pharmacy is the cornerstone of McKesson’s Sponsored Clinical Services Network. We are committed to providing our pharmacy customers with new forms of clinical services and technologies that not only result in healthier and more connected patients, but also provide compensation to pharmacists for their clinical expertise.

McKesson’s Sponsored Clinical Services Network is the industry’s largest active patient support network with significant experience implementing adherence support programs. Building on our partnerships with many of the largest pharmaceutical manufacturers in the industry, pharmacies active in our network have implemented innovative clinical services programs, such as delivering unique face-to-face adherence coaching, refill reminder letters and text messages, as well as opportunities to support patients in finding and participating in valuable clinical research. In 2011, participating pharmacies earned $1 million in service fees for providing patient support services and supported an estimated one-quarter million patients.

DSN: What else is McKesson doing to address this national issue?

Yelinek: McKesson recognizes that effective support of medication adherence requires an integrated effort from all healthcare stakeholders: physicians, pharmacists, employers, payers and pharmaceutical manufacturers. We believe we can help facilitate this collaboration through a patient-centered approach designed to educate patients and motivate them to actively manage their health and stay on therapy.