How to Improve Medication Adherence Within the Pharmacy

Total Pharmacy JournalTotal Pharmacy June 2024
Volume 02
Issue 03

Medication nonadherence can account for up to 50% of treatment failures and over $500 billion in annual health care costs.

At the Spring 2024 Total Pharmacy Solutions Summit, held virtually on April 13, Kelly Malkamaki, RPh, senior product pharmacy analyst at AssureCare, led a discussion on the role of medication adherence in the pharmacy, focused on factors affecting adherence, tools for improvement, and impact on pharmacies.

“Medication generally defined as the extent to which patients take medications as prescribed by their doctors,” Malkamaki said.1 “This involves factors such as getting prescriptions filled, remembering to take medications on time, and understanding the directions.”

In pharmacy and other health care settings, medication adherence is crucial for minimizing errors and adverse effects for patients. Nonadherence can affect patient outcomes and create further financial and societal issues.

“Medication adherence is generally defined as the extent to which patients take medications as prescribed by their doctors." | image credit: Sherry Young /

“Medication adherence is generally defined as the extent to which patients take medications as prescribed by their doctors." | image credit: Sherry Young /

Medication Nonadherence

Before understanding the proper methods of successfully executing medication adherence, it is important to know about nonadherence and the dangers it poses to pharmacies and patients. Malkamaki supplied her audience with a few eye-opening statistics on nonadherence.

“We know that 50% to 60% of patients take their medications improperly or not at all. The results of these statistics can account for up to 50% of treatment failures, roughly 125,000 deaths annually, [and] up to 25% of hospitalizations each year in the United States. These [nonadherence] statistics account for over $500 billion in health care costs annually,” Malkamaki said.1

Medication adherence is a complex issue influenced by various factors. Nonadherence should not be blamed on a patient; instead, pharmacists must do their due diligence in properly educating and communicating instructions to maximize adherence.

Malkamaki gave a real-world example of how nonadherence can steer a patient with diabetes down a frightening path. “Again, you take an at-risk patient like a [person with diabetes who] doesn’t finish a course of antibiotics, and this can quickly lead to sepsis in a very costly, scary hospital stay,” she said.1

READ MORE: Telepharmacy Empowers Pharmacists Practicing in a Changing Landscape

Improving Medical Adherence

Malkamaki then detailed some simple steps to improving adherence through increased refills, patient-pharmacist relationships, and more. “Improving patients’ medication adherence by increasing the number of prescription refills will lead to overall increased profitability for the pharmacy. A standard maintenance medication can typically be filled 13 times in 12 months. By increasing the number of prescription refills, you will help to improve Medicare star ratings and your equip measures. This will then lead to better reimbursements from the PBMs [pharmacy benefit managers] and even better contracts with them, ultimately helping to reduce the DIR [direct and indirect remuneration] clawbacks, which we know are currently impacting the bottom line at the pharmacy,” Malkamaki said.

In the pharmacy, an increase in medication refills is almost always a win-win for pharmacists and patients. It leads to increased customer loyalty and profit margins for the pharmacy’s bottom line.

Malkamaki also discussed pharmacy services administrative organizations and how good relationships with these groups can lead to even better relationships with PBMs.

Among other more specific factors that can improve medication adherence in the pharmacy, maintaining good relationships with outside entities and increasing prescription volumes are the best ways of maintaining adherence while increasing profits.

READ MORE: Measuring Medication Adherence: Exploring Issues and Better Solutions

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1. Malkamaki K. The crucial role medication adherence plays in pharmacy today. Presented at: 2024 Total Pharmacy Solutions Summit; April 13, 2024; virtual. Accessed May 9, 2024.
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