Helping patients follow the script
On the face of it, adhering to a medication regimen seems pretty straightforward — get a prescription from your doctor, get it filled at your local pharmacy, and take the medication as directed. But according to Dr Victoria Garcia Cardenas, a lecturer in pharmacy at the UTS Graduate School of Health, the reality is much more complex.
“There are approximately 150 barriers that have been identified for medication non-adherence — things like the cost or side effects of medication, patient access to general practitioners, or a lack of symptoms that falsely lead patients to believe the medication is unnecessary,” she says.
These barriers have resulted in over 50 per cent of patients with chronic conditions, such as HIV, hypertension, asthma and diabetes, failing to take their medications correctly. In turn, patients are experiencing negative health outcomes, which are leading to increases in emergency department visits and hospital admissions, all of which come at significant cost to the health system.
In response, Garcia Cardenas and her team are embarking on a research project that uses the expertise of community pharmacists to support patients with chronic conditions to achieve medication adherence.
“In our proposed program, every time a patient goes into the pharmacy with a prescription for a chronic condition, the pharmacist would systematically assess their adherence and identify the barriers that prevent the patient from taking their medications as prescribed,” Garcia Cardenas says.
While many patients might associate medication management with visiting their GP, pharmacists are usually the health practitioners that patients interact with immediately prior to starting a medication regimen
“Chronic patients usually have to go to the pharmacy on a monthly basis to collect their medications, so I think pharmacists are really well placed to ensure that patients are using their medications correctly,” says Cardenas. “They are also very accessible — every patient can access a pharmacy if they need to.”
The aim is to implement the program in the majority of Australian pharmacies, giving patients easy access to professional advice that will assist them to optimise their health and subsequently mitigating the economic impact of medication adherence issues.
The research team is currently finalising a systematic review to understand the cost of individual chronic conditions to the health care system’s bottom line.
The next step will be to pilot the medication management program in a pharmacy setting, pending the outcome of a recent funding application to the Pharmacy Trials Program.
Photographer (V Garcia Cardenas): Rachael Brown