Pharmacy Insights: News & Trends

Pharmacists Offer Best Defense Against Nonadherence

A recent study outlines the critical role pharmacists play in improving patient outcomes and lowering health care costs. Based on their review of 40 years’ worth of adherence studies, researchers found that patients who interact faceto- face with their local pharmacist are more likely to take their medicines as prescribed.

Hospitalizations and complications related to nonadherence cost the health care system an estimated $290 billion each year, according to the study’s sponsor CVS Caremark. The findings pave the way for interventions that capitalize on pharmacists’ unique combination of medication expertise and neighborhood accessibility.

The retrospective analysis, performed by researchers from Harvard University, Brigham and Women’s Hospital and CVS Caremark, sought to identify the best means of communicating with patients about adherence issues. Pharmacists, hospital-based nurses, and physicians were evaluated, as were different types of electronic and in-person communication.

“There have been many studies on the subject of boosting adherence. We decided it was important to review the total body of work to determine which communication channel had the greatest impact,” said lead author William Shrank, MD, MSHS, of Brigham and Women’s Hospital and Harvard University. To complete the study, Dr. Shrank and his team selected 168 studies from group of more than 6500 reports published in medical journals between 1966 and 2008.

Of all the interactions evaluated, in-store conversations with pharmacists had the strongest impact. Nurses who spoke with patients as they were discharged from the hospital were the second most effective. Both types of inperson communication delivered better results than physician-provided medication instruction.

Letters, faxes, and printed brochures were considered “low impact,” with little effect on adherence. Multimedia campaigns using videos and interactive technology were slightly more successful, but were still no match for face-to-face counseling provided by pharmacists. When conducted in person rather than on the telephone, conversations between patients and pharmacists were twice as effective at boosting adherence.

Study author Troyen A. Brennan, MD, MPH, executive vice president and chief medical officer of CVS Caremark, said the findings “offer payers, health care providers, and policy makers guidance about how to develop programs that improve patient adherence.”

“We know that pharmacists and nurses are among the most trusted health care professionals. This study shows that trust translates into effective patient communications,” he added.

1 in 6 Americans Bought Drugs From Rogue Online Pharmacies

More Americans are turning to illegal Internet pharmacies to purchase prescription drugs, according to a new survey conducted by the Partnership at Drugfree.org. The survey found that a total of 36 million patients, or 1 in 6 adults, purchased medications online without a prescription.

The new data was released in December at the White House Intellectual Property Health and Safety Forum. The survey was funded by the Alliance for Safe Online Pharmacies (ASOP), whose members include the American Pharmacists Association and the National Association of Chain Drug Stores.

“It is a real wake-up call that so many Americans have engaged in this dangerous behavior,” said Victoria Espinel, US Intellectual Property Enforcement Coordinator. Espinel and others met at the forum to discuss issues related to intellectual property theft, including the production and sale of counterfeit medicines.

According to ASOP, more than 95% of Internet organic search results lead patients to rogue online sellers peddling unapproved and potentially counterfeit medicine--without a prescription. Experts say more must be done to educate patients about the dangers of patronizing these fraudulent businesses.

“Consumers need to understand that the products they receive from Internet drug sellers are often not the same, FDA-approved medicine that they could get from a legitimate pharmacy. Products sold on rogue Web sites may be ineffective, harmful, or worse,” said Libby Baney, an advisor to ASOP.

To curb the practice, ASOP is partnering with a voluntary task force of 11 major Internet commerce companies, including American Express, Microsoft, Google, PayPal, and Yahoo!. The newly formed nonprofit group aims to shut down rogue sites and provide patients with legitimate channels for buying drugs online.

In the meantime, ASOP plans to pursue further research on why patients engage in the risky business of buying medicines from illicit online sellers. “We are eager to partner with the 11 Internet commerce companies announced today who have agreed to take a stand against this public health threat,” Baney said.