Combining free medications with counseling by a pharmacist has helped move the needle a bit further. Pazella notes that pharmacists are on the front line of patient engagement and in the perfect position to help with adherence in terms of explaining the purpose of medications, how to take them, and the importance of staying on them.
According to the NCPA report card, a personal connection with a pharmacist or pharmacy staff is a leading indicator of medication adherence "They can answer patient questions about drug safety, interactions between multiple medications, and anything that might prevent a patient from taking their medications on a regular basis," notes Pazella.
Aetna also stresses medication adherence in a follow-up program for patients who have been prescribed an anti-depressant. A study from CVS Caremark released last week identifies patients with depression as having the lowest medication adherence rates [PDF].
Aetna's case management program for patients with chronic diseases also includes an adherence component where the nurses administer a short questionnaire to identify patients who may need additional attention to help them with adherence. That connection is very important.
"Generally we don't see compliance for adherence for any chronic disease where there is no intervention for more than 60% of the time after the first year," says Pazella.
While the program results are encouraging, Pazella admits that improvement in adherence is often gradual. "We see a 10% improvement here, a 3% improvement there, and a 5% improvement somewhere else. But, it does begin to add up."