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The Reality: Even Small Gaps in the Care Delivery Chain Matter

January 21, 2014
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When it comes to managing the care and the health of patients with chronic illnesses, even small elements matter

It seems increasingly clear that, as the healthcare system moves forward with an immensely diverse range of care delivery enhancements, that we are all finding out how important every element in care management is, down to what might seem to some like very minor elements.

In that regard, I found it interesting when I came across a press release from the National Community Pharmacists Association. The Jan. 15 press release, under the headline, “Patients Benefit from Pharmacy-Provided medication Synchronization Programs,” noted the following: “Patients who opt in to medication synchronization programs offered through their community pharmacy average more than 100 additional days on therapy per year and are 30 percent more likely to take their medications as prescribed (or to be “adherent”) than patients not enrolled in a synchronization program, according the results of a new study project conducted by the National community Pharmacists Association (NCPA).”

The study conducted by NCPA and technology partner Ateb involved more than 1,300 patients enrolled in medication synchronization programs at 10 independent community pharmacies across the country. The researchers examined outcomes for patients receiving synchronization services, and those not receiving them. Nearly 90 percent of patients who received synchronized medication refills were considered adherent according to the parameters of the study, compared with 56 percent of those not receiving synchronized refills.

As a result of being enrolled in medication synchronization programs, those enrolled patients received an average of 3.4 more refills over a 12-month period than did non-enrolled patients. Does that seem like a lot more refills? Consider this: the patients enrolled in those programs averaged 5.9 synchronized medications per patient.

While such results may not seem earth-shattering in and of themselves, let’s look at the broader context of all this. The patients in this study averaged nearly six medications each that were involved in synchronization, meaning, the patients received automated phone messages asking them to come in and get their refills. In other words, these are patients with chronic illnesses. And as everyone knows who has read the literature, patient compliance with medication regimens is an extremely important element in maintaining and enhancing health among such patients.

So it seems as though this might be one of those “missing link” things—an element in care management that should be added to the long list of elements required for the success of the management of the care of patients with chronic illnesses. In this case, the link relates to neighborhood pharmacies and their role in patient management, rather than what happens directly in hospitals and medical practices.

But we should always keep in mind that the fact of such relatively small gaps overall sheds important light on how strongly every element in care management and patient management needs to be considered when knitting together optimal initiatives to enhance patient care management in our extremely complex healthcare system. Because really, even the smallest broken link can provide for failure when it comes to the health of those individuals whose health issues are both the most impactful and the most costly in our society.