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04/17/2014

Role of a Pharmacist in Medication Adherence - Across the Ages

Pharmacists are healthcare professionals known for their medication expertise to provide the best care for their patients. Using very unique skills such as medication knowledge, disease management, and patient education, pharmacists can improve patients’ medication adherence. Patients have the opportunity to contact their local pharmacist through multiple ways to develop a connection with their pharmacist and receive the best treatment. Focusing on pharmacists’ relationships with patients of various age groups can help determine ways to improve overall medication adherence.

Pediatrics:  Pharmacists play an important role in the well-being of pediatrics. Factors contributing to non-adherence may include minimal parental support, improper timing of dosage, and even inaccurate dosing. A study shows that the intervention of pharmacists counseling patients and families in regarding to medication regimen improves health outcomes for pediatrics. Accurate dosing and timing of doses also play an important role in treating children. Therefore, pharmacist’s role in electronic scripts allows for safe pediatric prescribing, when prescriptions include child’s age, weight, and proper directions to minimize miscommunication. Pharmacists can continue to be involved in a patient’s care, as the child becomes a young adult.

Young Adults:  When people aged 16 to 24 are diagnosed with a disease, it can be extremely difficult for individuals to understand their condition, medication purpose and still be adherent to therapy. Pharmacists can play an active role in managing these barriers of limited disease knowledge, minimal support from family and friends, and fear of adverse reactions. For example, pharmacists are in a key position to communicate with young adults diagnosed with HIV about the  the importance of 100% medication adherence, missed dose scenarios, and management of adverse effects.  Pharmacist can even provide details of the disease state and how the patient  can contact a local support group.

Adults:  As patients grow older, issues such as medication expenses, comorbidities and health literacy may contribute to improper management of therapy. Many adults are also taking multiple medications to manage disease states such as asthma, diabetes and hypertension. A study conducted in Spain shows that community pharmacist intervention significantly improved asthma control. Pharmacist interventions included explaining inhaler techniques, distinguishing between acute verses chronic asthma management, increasing pharmacy visits and stressing the importance of adherence. Thus pharmacist contribution greatly assists adult patients with adherence issues.

Elderly: Additional barriers develop as patients continue to age, such as polypharmacy, medication perception, and even growing disabilities. Pharmacists can play a significant role in patients’ adherence levels as seen by the study results, conducted in patients >65 years old, at Walter Reed Army Medical Center. There was a significant reduction in systolic blood pressure and an increase in adherence for those patients in pharmacy care compared to usual care. Interventions used in the study such as individualized medication education, blister packs, and regular follow up visits can be adapted into all pharmacy practice settings. The elderly population needs constant assistance and it is a great place for pharmacists to intervene by small modifications such as providing large font labeling, easy open caps, timely refills and patient education.

As patients of all ages get sick, they go to their doctor, receive a prescription, fill the prescription at a local pharmacy, take medication home and then return to the pharmacy for refills. This timeline of events repeats every time someone is sick. Therefore, pharmacists play an integral role in  patients’ medication therapy management and can help improve adherence. Focusing on different age group barriers and finding solutions, can contribute to the development of a relationship between the patient and the pharmacist, to receive and provide the best care.

Sheenu Joseph, PharmD ‘15

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