Medication adherence rates for most chronic disease medications hover around 50-60 percent. This results in sky-high healthcare costs and preventable morbidity or mortality. Patient intervention programs can promote adherence, but choosing the right tactics is critical.
All tactics may be effective in some circumstances, but the right tactics in any individual scenario often depend on who is overseeing the program. Payers, pharmacies, and pharmaceutical companies have different goals, levels of patient access, and options for supporting patient compliance, and therefore should approach interventions with different tactics.
So what does the evidence show about effective adherence interventions?
Pharmacy Intervention Tactics
Pharmacists are in a unique position to develop meaningful relationships with patients and use the trust they earn to encourage medication compliance. Face-to-face counseling, text messages, simplified medication regimes, and motivational interviews can all support patient medication adherence.
Pharmacies can also support the mission of greater compliance by minimizing adverse effects, thereby improving clinical quality measures. This includes counseling patients about their medications and advising when a medication may be unnecessary or harmful. Adherence packaging and strategies to promote medication access, such as prescription drug cards, may also help.
It’s critical to maintain a blame-free environment. Patients who are noncompliant with medication do not do so maliciously; after all, they are the ones who suffer the adverse effects. Pharmacists must instead listen to patients’ concerns and hardships, then develop strategies to overcome them.
In-person patient education proved effective in the Asheville Project, a long-term cohort study set in 12 community pharmacies in Asheville, North Carolina. The program used in-person pharmacist education to improve adherence in patients with diabetes, ultimately leading to improved clinical outcomes, reduced adverse events, and decreased costs.
Payer Intervention Tactics
Payers can incentivize pharmacies to use the above intervention tactics, but they can also target providers and patients.
For example, a study in the Journal of Managed Care & Specialty Pharmacy looked at how a multichannel adherence intervention affected members’ medication adherence and health plan quality performance measures for two Medicare Advantage Part D plans. The intervention included a daily prescriber-directed 90-day retail refill component and a weekly member-directed refill reminder component.
For the 90-day refill component, form prescription letters were sent by fax to prescribers of members who had filled a 30-day prescription. If their prescribers approved the refill, members were notified that a 90-day refill was available at their retail pharmacies. For the weekly refill reminder, weekly scans of pharmacy claims were used to identify members’ refills patterns. Members who were seven days late received the letter. The study found adherence increases for both plans using these interventions.
Blue Cross Blue Shield Arizona (BCBSAZ) began using text messages in 2019 to target patients with cardiovascular disease, respiratory disease, and diabetes, covering 13 drugs in total.. As an added incentive, members using the messaging program who fill their prescriptions on time receive $45 to $50 off their copay.
Pharma Intervention Tactics
Pharmaceutical companies don’t typically have access to the detailed patient data available to pharmacies, providers, and payers. Because of this, their medication adherence programs are usually brand-focused, educating patients about a drug or encouraging access. Patient engagement call centers are the most popular option.
Dan Sontupe, the associate partner and manager of The Bloc’s Value Builders, says pharma companies can drive adherence by promoting patient health. His marketing agency partnered with the Commission for Case Manager Certification to create “brand-agnostic” case management tool kits that help “pharma manufacturers meet patients where they are with materials to help support disease control and health-management goals.”
Additionally, “Emails, texts, Facebook messages, and tweets provide further avenues for all-encompassing patient engagement.”
How AllazoHealth’s AI Improves Patient Interventions
AllazoHealth’s artificial intelligence (AI) technology makes patient interventions more effective, no matter which tactics pharmacies, payers, and pharmaceutical companies utilize. The most effective, cost-efficient measures target smaller groups of patients with higher risk, rather than an entire patient population. For example, research shows that certain chronic medical conditions have lower compliance rates.
The AI accurately predicts which patients are at risk for non-adherence or other gaps in care, drawing on demographic data and past patient behavior. It then identifies which patients are most likely to respond to which interventions and recommends patient outreach by channel, content, and timing to deliver the most effective engagement.