Looking for ways to increase medication compliance by challenging patients -- such as the elderly and those with mental illness?
When Chris Nadeau, PharmD, a fourth-generation pharmacist from Maine, was looking for a way to increase compliance among his geriatric patients he discovered that there was also a pattern of non-compliance among two groups of his patients.
“We saw a trend with lack of compliance in the behavioral/mental health and non-English speaking community due to misunderstanding or misinterpreting directions. Many of these patients, particularly patients with mental illness, are unable to access transportation services to pick up their medications, further decreasing compliance,” said Nadeau.
The challenge for Nadeau was to get patients to not only take their medications on time but also to make sure that the medications got to them.
After searching the marketplace for a better packaging system, Nadeau selected Omnicell’s SureMed multidose blister cards.
The way it works is that when patients sign up for the program, the pharmacy contacts their doctor to get a full medication list and confirm that their meds are current. Patients receive their meds in multidose blister cards that includes directions on the package - how many to take and when along with a photo of what the pill looks like. The blister cards have perforated tear off doses with a medication list printed on the cover.
Currently Nadeau has 200 patients using the cards. “We pack their meds and we put people into different groups depending on the location within our delivery area,” said Nadeau.
The delivery service, noted Nadeau, is provided free-of-charge and so far, feedback has been overwhelmingly positive.
Nadeau added that doctors have been pleased with the program and are telling their patients about it, especially those who are unable to understand how to take their medications.
“When it comes to this packaging, they know how to take their medication– they punch out a certain blister a certain time a day – they don’t have to worry about dose changes or splitting tablets - so whatever pills are in the pack. They know they are going to take them appropriately.”
Outcomes medication compliance
Nadeau asserted that compliance has been by far the biggest advantage of the system. “We noticed that our patients take their meds on a more regular basis, making them more effective. With this system, patients can track if they actually took their doses because the blister is visibly broken if they took it and the med isn’t there anymore.”
Nadeau said that he has also incorporated medication synchronization into the system.
Nadeau said that his philosophy as an independent pharmacist is to always look for ways to improve patient care. “Because people are taking their meds on a more regular basis and are more compliant, we have had several dose decreases with some of the oral antidiabetic meds.”
Anthony Vecchione is Executive Editor of Drug Topics.