While medications to treat mental illness are a major source of drug spending, that money may be going to waste if patients don’t take their drugs as prescribed. Presenting at the recent Mental Health Summit Vancouver, Allison Nourse, national director of pharmacy innovation at Pharmasave Drugs Ltd., explored the ways community pharmacists can optimize medications and improve adherence to drug therapy.
“Approximately 50 per cent of patients don’t take their medication as prescribed, and adherence rates are lower for psychiatric medications compared to medications for other conditions,” said Nourse. “Low adherence can lead to a relapse of the condition, lower productivity or presenteeism, absenteeism from work and, ultimately, higher costs for employers and the health-care system.”
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When patients are adherent, it increases the chances of improved functionality and entering remission, said Nourse. “In turn, this leads to more productive employees with improved symptom management, less medication wastage and cost savings on long-term and short-term disability and days off work.”
As accessible medication experts, community pharmacists can do a lot to boost adherence, starting with a medication review with the patient to discuss which drugs are necessary, safe, effective, affordable and easy to take. They can also educate plan members about medications and expectations, investigate options to save costs, simplify the medication regime, offer medication synchronization to co-ordinate refills, provide reminder tools and followup and collaborate with other health-care professionals within the patient’s circle of care.
“People are more adherent when they are part of the decision-making process, understanding how the medicine works, knowing when to expect improvement and being aware of what side-effects to watch out for,” said Nourse. “Pharmacists can discuss symptom improvement and side-effect management.”
Read: A look at pharmacists’ role in supporting drug adherence
As technology and health care advance, new tools are available to not only encourage adherence but also improve the efficacy of drug therapy. Precision medicine is an emerging approach to disease treatment that takes into account individual variability in genes, environment and lifestyle for each person. Several pharmacogenomic tests, which show the relationship between genetic variations in how the body responds to medication, are now on the market as simple saliva tests.
“This evolving technology indicates that one size does not fit all, as people respond to medication in different ways. Some respond better to a lower or higher dose or an alternative medication,” said Nourse. “Pharmacogenomics can mean less trial and error with medications, less risk of side-effects and earlier, optimal therapeutic outcomes.”
Read more stories from the Mental Health Summit