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May 2018
Take this advice to help ensure your Medicare patients take their medications
Medication adherence is critical to Medicare patient quality outcomes. The Centers for Medicare & Medicaid Services has stressed the importance of medication adherence by including three triple-weighted clinical pharmacy measures in the star ratings program for Medicare Advantage health care plans.
The three medication adherence measures cover medications for diabetes, hypertension and cholesterol. Member compliance for these three measures is based on the percentage of plan members who fill their diabetes, hypertension or cholesterol prescriptions often enough to cover 80 percent or more of the time they’re supposed to be taking the medication.
Why are patients non-adherent and what can you do to help them?
Here are common reasons why patients don’t take their medication as prescribed and ways you can encourage their compliance.
The patient forgets to refill the prescription on time. |
Consider writing 90-day supplies of any maintenance medications. A study published in The American Journal of Managed Care showed that patients on 90-day supplies were more adherent than patients on 30-day supplies. |
A patient thinks the medication costs too much. |
If cost is a concern, especially with a brand-name medication, consider switching the patient to a lower-cost generic medication if possible.
If there is another brand-name medication in the same class, one brand may be preferred over the other by the patient’s health care plan and have a lower co-pay.
It’s not recommended for physicians to prescribe a double dose to financially disadvantaged patients and tell them to cut the medication in half. This could result in mismatched printed and verbal directions, which could lead to patient or caregiver confusion. |
A patient isn’t convinced that the medication is important, or the patient thinks taking the medication would be harmful. |
While any drug carries possible risk, stress the potential adverse consequences for the patient if he or she doesn’t take the medication as prescribed. The benefits of the medication should outweigh the risk.
Tell the patient to let you know immediately if he or she experiences side effects. The patient shouldn’t stop or change the regimen on his or her own, because there are ways to manage side effects.
For example:
- Lowering a dose
- Taking medications with food or water
- Taking medications at bedtime instead of during the day
- Changing from an immediate-release to an extended-release formulation
- Changing to a different medication within the same class
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It’s difficult for a patient to remember taking the medication when he or she must. |
Offer the following suggestions:
- Using weekly or monthly pill boxes
- Setting cellphone reminder alarms
- Making use of medication adherence smartphone apps
- Placing medications in a highly visible area (but in properly closed containers and safely out of reach of children or pets)
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A patient is unable to get to the pharmacy because of unreliable transportation. |
Inform the patient that many pharmacies offer delivery services, and mail-order pharmacy is an option as well. |
As a physician, you can have a huge effect on medication adherence. Your insight can help identify reasons why patients struggle with medication adherence, and your expertise can help guide them to healthier outcomes.
Sources:
None of the information included in this article is intended to be legal advice and, as such, it remains the provider’s responsibility to ensure that all medical services are done in accordance with all applicable state and federal laws and regulations.
**Blue Cross Blue Shield of Michigan doesn’t own or control this website.
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