According to the Centers for Disease Control and Prevention, “medication adherence is a complex behavior influenced by factors along the continuum of care, relating to the patient, providers and health systems.” Finding out why a patient has not been adherent to their medications can be a challenge. A new UNMC project is working to identify and eliminate the health disparities that keep a patient from taking their medications. 

The Quality Measures Alignment Group, a group of pharmacists from Nebraska Medicine, UNMC and the Nebraska Health Network, began the work at the beginning of 2022 for this project. They created a template that walks UNMC students through the process of working up and calling patients who have been identified to be non-adherent to taking their medications through a Medication Possession Ratio (MPR), which is measured by a patient's refill count and pill count over the course of prescribed therapy. 

Patients that have below 80% MPR are at greater risk for poor health outcomes, including high ED and inpatient utilization. Adam Schulte, PharmD, NHN Pharmacist, helps evaluate non-adherent patient trends across the ACO, providing insight and guidance on underlying causes for non-adherence. 

“We say it’s an adherence project, but really it’s a way to contact the patient to reach out and see if there are more needs the patient has in order to help their health care in general,” said Logan Franck, PharmD, BCACP, from Nebraska Medicine. 

The project gives student pharmacists real-life experience to evaluate non-adherence and have those difficult discussions with patients. Part of this discussion includes highlighting potential reasons for non-adherence including: forgetfulness, cost, transportation issues, availability of medications, taking medications differently than prescribed. 

After documenting the patient’s reasons for non-adherence, the information will be used to see where most disparities are occurring. In addition to helping patients and giving students real-life experience, the project will bring to light care delivery inconsistencies and improve the patient experience. Nebraska Medicine has specific solutions that each non-adherent category can potentially resolve and is well-equipped to make an impact in these patients' lives. 

“Finding out what health equity problems exist and how to resolve them has been an issue. This is an opportunity to identify them and let patients know that as providers, we do care,” Dr. Franck said. 

The project aims to identify and resolve barriers that are common in non-adherent patients. This will ultimately provide better care for patients. UNMC student pharmacists are expected to start calling patients in the Summer of 2023. 

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