Pharmacists’ Role in Improving Medication Adherence: Medication Therapy Management and Post-Discharge Care

This is the second article in a series on medication adherence.

Medication Therapy Management (MTM) and Post-Discharge Care are two strategies that are particularly important when discussing medication adherence as it relates to acute care. With at least one-third of adverse drug events that result in hospital readmissions being related to non-adherence, hospitals should be highly invested in ensuring patients know how to properly manage their medications.

Medication Therapy Management

Acute care pharmacists can play a key role in MTM by connecting with a patient during their hospital stay and discussing potential pitfalls leading to non-adherence such as:

  • Cost
  • Schedule
  • Individual patient concerns

And by following up with the patient post-discharge, pharmacists can lay the groundwork for how the patient will manage their meds and develop long term successful management habits.

Although the physician plays an important role in patient education, the pharmacist is an ideal caregiver to offer this support. Hospital pharmacists have a better sense of drug interactions and may seem more approachable from a patient perspective. This results in a more open dialogue, allowing the patient to voice any concerns beyond affordability such as scheduling or lack of understanding about the purpose of a medication.

Post-Discharge Care

When continued into post-acute care, MTM allows pharmacists to continually evaluate the practicality and safety of a complete medication regimen, including vitamins and over the counter drugs. Oftentimes, physicians may prescribe a new medication without thinking of the overall impact an additional pill would have on the adherence of that patient.

MTM allows the pharmacist to work with the patient, and the physician if necessary, to identify the hierarchy of medications. If a low-importance medication has a complicated delivery schedule and is causing the patient to become non-adherent with their other meds, it may not be worth the added risk.

Post-discharge follow-up care gives the patient the opportunity to voice any immediate concerns once they start administering their medications. Offering additional post-discharge care through a pharmacist has been shown to decrease rates of hospital readmissions. In fact, many acute-care facilities are now forging partnerships with community pharmacists to follow-up with patients directly and begin building long-term relationships.

According to one pharmacist conducting post-discharge phone calls in Texas, “Pharmacists are more adept at identifying problematic [drug] combinations and inappropriate doses for specific patients, so I think this is an area with great potential for [the profession].”

During these calls, pharmacists identified medication issues in 22% of patients. Thanks to pharmacists detecting and amending these errors, many people were able to avoid being hospitalized for improper medication use.

Cooperative Care

Even physicians agree that, in some instances, their patients are on so many medicines it’s hard to take them all properly. With even healthcare providers struggling with this responsibility, it’s important to support patients’ endeavors to manage their own medications. To best achieve this, a cooperative care team between the acute and post-acute care setting is necessary to ensure optimal transitions out of the hospital.

Please share your thoughts below and don’t miss the next post in this series discussing the importance of medication synchronization and adherence packaging.

View the previous post on medication adherence here.

Additional Resources:

Pharmacy Practice News

Pharmacy Times

American Society of Health System Pharmacists

American Society for Automation in Pharmacy

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