A 2006 National Community Pharmacists Association report found that nearly three-quarters of American patients admit to not taking medications as directed. The NCPA estimates that this non-adherence results in extra healthcare costs of approximately $100 billion per year due to increased hospitalizations, doctor visits, lab tests, and nursing home admissions. For patients over 65, the problem of non-adherence is particularly acute. In a 2011 survey, the National Institute of Health examined numerous barriers impeding medication adherence in seniors, finding that patient memory, drug cost, dosing frequency, difficulties acquiring medication, and perceived drug effects constitute the greatest barriers to patient drug adherence.
Since doctors share pharmacists’ concerns over drug non-adherence, it provides an effective avenue for increased collaboration between pharmacists and local physicians. Pharmacists have the capacity to help patients increase their drug adherence, which can directly affect patient health outcomes. Developing closer relationships with local physicians is a great method for pharmacists to improve their patients’ health while potentially improving business. Since pharmacists interact with patients on a more frequent basis than physicians, they are more likely to be aware of issues regarding drug affordability and patients’ understanding of drug effects. Resolving these issues can lead to increased patient prescription adherence. Pharmacists also tend to have a more extensive record of a patient’s medication history, which can include prescriptions from both primary care physicians and specialists. Pharmacists can use this knowledge to alert doctors about negative drug interactions and suggest possible therapeutic alternatives. In addition, pharmacists can determine whether the drug prescribed is within the patient’s Medicare part D plan and offer generic alternatives for the physician if the medication is not covered.
Whenever contacting physicians about possible drug adherence issues, pharmacists should remember that physicians often find themselves short on time. Like pharmacists, doctors maintain very busy schedules and often work in high-pressure environments. To save time and alleviate stress, pharmacists should be direct and informative when raising potential issues, and should always offer a possible plan to address medication problems. Consistently having productive and respectful interactions with physicians can lead to a deeper professional relationship, which further improves patient care.
In addition to improving patient health, fostering relationships with local physicians can provide pharmacies with a number of benefits. Most directly, increased collaboration can lead to more patient referrals, as doctors who are familiar with a local pharmacy are far more likely to refer patients there. Indirectly, maintaining positive contact with local physicians can lead to higher reimbursements through increased patient drug adherence- meaning patients actually fill their prescriptions instead of avoiding purchasing them. Pharmacists also can gain more reimbursements by alerting doctors to the new regulations regarding statin therapy. Though statin therapy is recommended for patients over 40 with diabetes, many physicians do not prescribe it, or are aware of the current ACC/AHA and ADA guidelines. Doctors who are familiar with local pharmacists are more likely to consider the pharmacists’ recommendations for adding statin therapy to a patient’s drug regimen. In addition, this can potentially lead to an increase a pharmacy’s Medicare Star Rating. A high star rating often results in lower DIR fees, which leads to higher reimbursements for pharmacists.
In summary, an increase in collaboration between pharmacists and local physicians as a means for increasing drug adherence is a win-win solution for doctors, pharmacists, and patients alike.