MANAGED CARE February 2012. ©MediMedia USA
Disease management programs that rely on phone calls to encourage medication adherence can be greatly enhanced by offering patient/pharmacist face-to-face counseling, says a study in Health Affairs.
“An Integrated Pharmacy-Based Program Improved Medication Prescription and Adherence Rates in Diabetes Patients” concludes that “the in-person interaction between the retail pharmacist and patient was a contributing factor to improved behavior” (http://content.healthaffairs.org/content/31/1/120.abstract  — registration required).
The study was conducted by researchers at Harvard University, Brigham & Women’s Hospital, and CVS Caremark by analyzing the pharmacy claims (between October 2009 and April 2010) of a large manufacturing company in the Midwest.
The intervention group was comprised of over 5,000 patients with diabetes. This group received in-person counseling. The control group of over 24,000 patients did not receive specialized in-person counseling. The employer saved more than $600,000 thanks to cost avoidance, while the counseling cost about $200,000 — a 3:1 return on investment.
The study says that the program “delivered sustained gains in adherence and initiation of therapy, which waned once the program ended. In a health care system eagerly seeking programs that can reduce costs and improve care, such simple, pharmacist-based counseling programs to improve adherence to existing medication regimens and initiate missing therapies should be of great value.”
When pharmacists contacted both patients and their doctors, it increased therapy initiation rates by as much as 39 percent for the full sample, and an even higher 68 percent for patients who received counseling at retail stores.
The counseling took two to five minutes, and first-fill meetings were accompanied by a brochure that cost 50 cents per copy.
Some in the intervention group belonged to the CVS Caremark pharmacy benefit manager. “[A] pharmacy technician would phone a patient, explain the purpose of the call, comply with the privacy regulations of the Health Insurance Portability and Accountability Act of 1996, and transfer the call to a pharmacist, who would deliver the counseling session. On average, the technician portion of the call took 4.4 minutes, and the pharmacist portion, 11.5 minutes.”