The challenge of overcoming poor medication adherence, which causes treatment failures, unnecessary medication switching, and thousands of deaths per year, remains an ongoing issue in healthcare. PDR has solutions that can help prescribers, patients, and pharmacists improve performance in this area. Medication adherence is gauged by patients' conformance to provider recommendations, specifically the timing, dosage, and frequency of medication use. Unfortunately, nonadherence is quite prevalent, with estimates ranging from 12–30% of patients never filling prescriptions at all. Of those who do fill prescriptions, about 12% do not take the medication at all, 29% stop taking it early, and 22% take less than prescribed. Not taking medications as prescribed can result in negative health outcomes (especially among those with chronic conditions) and raise the overall cost of healthcare. Lack of adherence can cause a patient's health to further decline, leading to costly and time-consuming care, such as hospitalizations. Appropriate medication adherence is essential for effective treatment and ultimately for reducing the expense of healthcare.

The reasons for a patient's nonadherence may be complex and even differ from medication to medication. A lack of commitment to therapy—which can include lack of understanding of the condition being treated and the rationale for the medication—is a major contributor to nonadherence. Misunderstandings regarding the importance of therapy, the benefits of treatment, and incorrect expectations regarding therapy (e.g., when symptoms may resolve or how long therapy must be continued) are also contributing factors. These can all be complicated when patients have a preference for non-drug therapies or no therapy at all—a belief that the patient may or may not reveal to their healthcare provider. Coverage/financial difficulties such as an inability or unwillingness to bear the expense are common—particularly for patients on multiple, chronic medications. Patients may not hear or retain the information about their condition and/or the reason for their prescription due to communication barriers during the provider-patient encounter or the lack of educational materials written in plain language. Sometimes patients are reluctant to take a medication when they are not aware that the drug does not provide immediate improvement in symptoms, when they are taking complex therapies, or the drug causes unwanted adverse reactions. All these and more are potential obstacles to achieving appropriate adherence.

PDR can help to overcome communication challenges/barriers and promote adherence through programs for healthcare providers, patients, and pharmacists. Support begins with key information at prescribers' fingertips in workflow, continues with specialized patient-friendly drug summaries, and is reinforced by tools that enhance provider-patient-pharmacist engagement. Communication programs in prescriber eRx/EMR/EHR workflow include information for prescribers and ScriptGuide, which is patient-friendly medication and condition information for patients and their caregivers. Prescriber messages vary among many types of clinically relevant topics, and support and inform the prescribing decision while encouraging effective medication use and discussion with the patient. Patient messages offer critical educational information, conveying details such as what to expect about continued therapy, reinforcing the health benefits of adherence, and promoting communication with pharmacist and prescriber when patients have questions or experience side effects. Increasing patient knowledge of their condition and confidence in their therapy significantly bolsters first-fill rates and adherence.

PDR helps continue the conversation with programs such as eCopay, where messages are triggered at the point-of-care to inform patients of a savings offer, and CarePoints, which includes medication education at the point-of dispensing with patient support messaging to encourage adherence to their prescription—including messages for patients who are late to refill and those who may have lapsed entirely. PDR also supplements patient education at the pharmacy with the ValueAdd messaging program, FDA-compliant Med Guides, and Vaccine Information Statements (commonly referred to as VIS). Communication programs for pharmacists reinforce education strategies by conveying vital information via PharmacistCare, which supplies announcements of new drugs or strengths, new indications, emergency information, and CE credit opportunities. A knowledgeable pharmacy staff is more effective at counseling and educating patients, which further promotes adherence.

PDR also offers the PDR Pharmacy Discount Card, which provides an average 38% savings on over 55,000 FDA-approved medications—including generics. Patients receive cards from providers who are enrolled in the program, by printing a card on PDR.net, or by downloading the mobile app (search "PDR Discount" in the app stores). This and the programs described earlier are among the many solutions that PDR offers. For more information about PDR's offerings, explore PDR.net. Please update or register your PDR profile to receive alerts and other critical drug information from PDR via email. Also, look for information from PDR within your eRx workflow—drug safety information, updates about dosing and formulary, patient support programs, and savings opportunities—all on your screen as you prescribe, at no cost to you or your patients. To learn more about PDR services in your eRx/EMR/EHR workflow, email us at EHR-info@PDR.net.

Salvatore Volpe, MD, FAAP, FACP, CHCQM
Chief Medical Officer
PDR