Balancing the Knife Between Medication Adherence and Pharmacy Workflow

Category: Pharmacy Advances Written by Dr. Charles Shively / November 8, 2014

GAME ON! It's About Medication Adherence and I'm Helping Myself®

As a practicing pharmacist, my days are already stretched. Another eight hours please® probably explains it best. Yet with the recent re-challenge proposed by the "A3".... the Adherence Action Agenda... offered by the National Council on Patient Information and Education (NCPIE), we've been challenged as pharmacists to do more...much more.

It is now time to co-join with our patients far more extensively than our previous medication compliance/consulting efforts and advance I'm Helping Myself® ? Might you be ready for the challenge? What does this mean to our daily workflow efforts?

I know we need advance the "I'm Helping Myself®" approach to medication adherence and individual healthcare. But how does this impact our daily pharmacy workflow efforts? I only wish I could go to my local ATM and ask for another eight hours today (not available at yours?). What other options do we pharmacists have to "gain" extra time during the workday to meet the challenge?

This Challenge Started in 2007...Believe It or Not

In 2007, the NCPIE called for a national mobilization to assist with a reduction in overall healthcare expenditures. This Enhancing Prescription Medicine Adherence: A National Action Plan offered 10 areas or priorities of necessary effort to deal with America's "other drug problem". How then do we best help our patient/customer to embrace the "I'm Helping Myself®" approach to improving healthcare quality of life?

The newest NCPIE call to action (October, 2013) Accelerating Progress in Prescription Medicine Adherence: The Adherence Action Agenda, is focused on priorities to stunt the poor medication adherence associated in the epidemic of persons with multiple chronic diseases. With the growing number of Americans taking numerous prescriptions medications (2-15/day), these individuals are at a higher risk of drug-drug interactions, adverse events and medication errors. How about the number of different physicians each individual may use? Researchers and public health officials put the avoidable costs associated with poor medication adherence among patients with multiple chronic diseases at $ 1.3 billion a year and rising. (IMS Institute for Health Informatics, June, 2013).

With our yearly continued position as a most trusted healthcare provider in national surveys, we have the unique opportunity to play a larger role in supporting "Let's Advance Healthcare® . Consider the number of opportunities anticipated by the larger population of patient/customers soon to be insured through the Affordable Health Care Act provisions...estimates suggest we will have some two (2) BILLION or more new opportunities(prescriptions) nationwide in 2014 which should allow us to engage our patients to help themselves with their medication adherence. With this "Perfect Prescription Storm® " forthcoming, we have a golden opportunity to impact. Will we pharmacists become adherents?

Are You an Adherent? Let's Pharmacy Up®

Webster's New Collegiate Dictionary defines an adherent (actually a noun) as a name given to one who performs the act of adherence and understands the act of being adherent...being consistent, giving support and maintaining loyalty. It would appear both pharmacists and their patients must each support the medication adherence agenda...not just one individual or the other. I genuinely believe now is the time for we pharmacists to Pharmacy Up®... perhaps a new "rally cry " for our profession?

Certainly one of my concerns as a pharmacist as I help to advance this medication adherence agenda is how active involvement will impact any pharmacist's available time during their daily pharmacy workflow events. There was a time earlier in my career...before many of the recent healthcare offerings we now complete (MTM, immunizations, care transitions, etc.)... where this opportunity to establish a more engaging pharmacist-patient encounter probably would not have impacted me to the extent it does today.

Recall when your knees didn't hurt after a 14 hour shift? How about when your last annual health exam had a cholesterol level below 200 and your A1C was below 6.5? Several years ago, I as a pharmacist, unknowingly became a member of the MAWG Club (middle age weight gain). How about you?

Recently however I chose to knowingly join a new club. It's the "I'm Helping Myself® (IHM) club. Many community and hospital outpatient pharmacists are now actively concerned about not only their patient/customer health but their own. Is this a co-join or bond to advance medication adherence? It would appear so.

Carving Out More Time...Balancing the Knife Between Medication Adherence and Pharmacy Workflow

How best to help our patient/customer embrace the "I'm Helping Myself" approach to improving quality of life and reducing the national healthcare cost? As a consultant pharmacist to community, outpatient hospital and long term care pharmacies, I now offer seven (7) key adjustments in pharmacy workflow dispensing activities and medication adherence approaches. These adjustments spell out the word ADVANCE:

Recommendation # 1

A -Assign traditional pharmacy workflow functions to the most efficient human resource

Recommendation # 2

D-Delegate to senior certified technicians as many possible steps in MTM and patient immunization

Recommendation # 3

V-Value your staff's daily effort by always telling them "Thanks for Coming in Today®"

Recommendation # 4

A-Assess where automated pharmacy dispensing options may add to your time-savings

Recommendation # 5

N-Nourish your co-join with patient customers through "bag stuffers" about medication adherence

Recommendation # 6

C -Challenge your pharmacy management software vendor to add a "multiple chronic disease" flag

Recommendation # 7

E-Ensure you review every filled prescription realizing that its approval for reimbursement will
soon become part of a pharmacy P4P® (pay for performance) mandate already in place with hospitals
Within each pharmacy, both pharmacist and technician can best determine which of these recommendations will allow improved pharmacy workflow and create the needed time-savings. One thing is for certain...the Adherence Action Agenda is going to demand considerable additional time to effectively implement. Automated pharmacy dispensing systems can greatly assist with this challenge. Pharmacy Up!

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Thank for sharing!

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