Strategies to Improve Medication Adherence in Aging Populations
Why investing time and resources in adherence solutions for Medicare matters
As Chief Medical Officer at Envolve Pharmacy Solutions, Dr. Ross Hoffman’s areas of focus include improving healthcare transparency, convenience and access, as well as leveraging technology to reduce waste. He believes by providing patients with more targeted and personalized information, they will gain greater control of their healthcare and lifestyle decisions. A board certified cardiologist, he obtained his bachelor’s degree in Chemistry from the University of Pennsylvania and MD from The University of Central Florida.
More than ten thousand individuals become eligible for Medicare each day. Many of those currently take medications or are at risk of a health event in which medications and recovery plans may be needed. Proactive, easy-to-understand, and easy-to-implement strategies that promote medication adherence are essential to achieving healthier members and managing costs. We discussed this topic with Ross Hoffman, MD, Cardiologist and Envolve Pharmacy Solutions Chief Medical Officer.
What challenge do you see as the biggest barrier to medication adherence in aging populations?
RH: Changing behavior. Simply put, habits are formed over time. Patients are often set in their ways and it can be difficult for them to alter their routines. This change requires more than just tools and strategies. We have found it also requires human connection, encouragement, and positive engagement. A follow-up structure influenced by data and a collaborative approach to therapeutic interaction allows seniors to regularly interact with a compassionate person who is knowledgeable about their situation and medications.
What methods of promoting adherence solutions have you found most widely accepted by the Medicare population?
RH: We have seen positive results with our Cognitive Behavioral and Motivational Interviewing techniques. Dealing with a complex condition may require daily, sometimes intense maintenance. It can become overwhelming and cumbersome to manage. We utilize person-centered initiatives, which are telephonic, pharmacist-led interventions designed to encourage individuals to take ownership of their health through personalized, frequent interactions. This focus on individual needs and preferences promotes adherence and behavior change by enhancing human connection and health literacy while providing credible, culturally competent guidance. Health literacy plays an important role in medication adherence for our most vulnerable seniors, many of whom have not utilized the health care system and have not established a trusted relationship with health care providers.
Additionally, the use of mail order, 90-day supplies, pill packaging and/or medication synchronization for maintenance medications are easy ways to promote adherence. Convenience and confidence in the care plan help to drive best outcomes for this special population.
Considering recent events of the COVID-19 pandemic, do you see a shift in acceptance toward virtual care for this population and how do you see these digital solutions impacting adherence?
RH: The impact of COVID-19 on the day-to-day lives of seniors has been significant, like it has for all of us. I don’t think anyone would disagree with that. Research shows that nearly 65 percent of seniors made some change to their medical care due to COVID-19, most often canceling or rescheduling doctor appointments. Industry-wide, and with this population in particular, we have seen a much higher than expected adoption rate of telehealth.
Regarding adherence, many seniors rely on their doctors to confirm their health status and current care plan. With the decrease of in-person appointments, it’s important that other measures are taken to ensure medication compliance. Transitioning vulnerable populations to home delivery, enhancing outreach measures, securing prescription refills, and coordinating follow-up virtual or other care are all tactics that improve adherence during this pandemic. Care coordination matters, and telehealth provides convenient, safe access during shelter-in-place. Timely integration of the telehealth experience with the primary physician’s practice and health record, further assures the optimal patient and provider experience.