A renewed Medication Adherence Alliance call to action: harnessing momentum to address medication nonadherence in the United States

Zullig, Leah L.; Granger, Bradi B.; Bosworth, Hayden B.

doi:10.2147/ppa.s100844

Cited by 12 publications

(9 citation statements)

References 33 publications

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“…This information is important to a variety of stakeholders in both the public and private sector, including local, state and federal public health and policy officials and pharmacy retailers, interested in better understanding the role of pharmacies in improving access and adherence to prescription medications. Although policy efforts—such as Medicare Part D—have focused on ensuring the affordability of prescription medications [ 18 ], non-adherence, which varies across localities [ 5 , 6 ], persists as important public health problem in the U.S. [ 19 ], suggesting access barriers, including pharmacy accessibility and the provision of pharmacy accommodations associated with access to prescription medications, are also important to consider.…”

Section: Discussionmentioning

confidence: 99%

The availability of pharmacies in the United States: 2007–2015

et al. 2017

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ImportanceDespite their increasingly important role in health care delivery, little is known about the availability, and characteristics, of community pharmacies in the United States.Objectives(1) To examine trends in the availability of community pharmacies and pharmacy characteristics (24-hour, drive-up, home delivery, e-prescribing, and multilingual staffing) associated with access to prescription medications in the U.S. between 2007 and 2015; and (2) to determine whether and how these patterns varied by pharmacy type (retail chains, independents, mass retailers, food stores, government and clinic-based) and across counties.MethodsRetrospective analysis using annual data from the National Council for Prescription Drug Programs. Pharmacy locations were mapped and linked to the several publically-available data to derive information on county-level population demographics, including annual estimates of total population, percent of population that is non-English speaking, percent with an ambulatory disability and percent aged ≥65 years. The key outcomes were availability of pharmacies (total number and per-capita) and pharmacy characteristics overall, by pharmacy type, and across counties.ResultsThe number of community pharmacies increased by 6.3% from 63,752 (2007) to 67,753 (2015). Retail chain and independent pharmacies persistently accounted for 40% and 35% of all pharmacies, respectively, while the remainder were comprised of mass retailer (12%), food store, (10%), clinic-based (3%) or government (<1%) pharmacies. With the exception of e-prescribing, there was no substantial change in pharmacy characteristics over time. While the number of pharmacies per 10,000 people (2.11) did not change between 2007 and 2015 at the national-level, it varied substantially across counties ranging from 0 to 13.6 per-capita in 2015. We also found that the majority of pharmacies do not offer accommodations that facilitate access to prescription medications, including home-delivery, with considerable variation by pharmacy type and across counties. For example, the provision of home-delivery services ranged from less than <1% of mass retailers to 67% of independent stores and was not associated with county demographics, including ambulatory disability population and percent of the population aged ≥65 years.ConclusionsDespite modest growth of pharmacies in the U.S., the availability of pharmacies, and pharmacy characteristics associated with access to prescription medications, vary substantially across local areas. Policy efforts aimed at improving access to prescription medications should ensure the availability of pharmacies and their accommodations align with local population needs.

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Section: Discussionmentioning

confidence: 99%

The availability of pharmacies in the United States: 2007–2015

et al. 2017

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“…2,3 Not surprisingly, efforts to better understand the determinants and facilitators of, and challenges to, adherence have proliferated in medicine and social science, contributing to a robust body of literature that can seem overwhelming. 4 In response to the ongoing need to optimize work with patient medication adherence in a manner that leverages social-behavioral science, the University of Alabama at Birmingham (UAB) hosted a conference, BUnderstanding and Improving Treatment Adherence: An Interdisciplinary Approach,^in February 2016. Our review and discussion of social-behavioral models of medication adherence provides a rationale for their wide-scale use, a brief sampling of HIV medication adherence models that can be generalized to other conditions and regimens, a synthesis of salient factors identified across multiple models, and practical recommendations for using evidence-based and evidence-informed adherence models to guide practice and research.…”

Section: Introductionmentioning

confidence: 99%

Advantages to Using Social-Behavioral Models of Medication Adherence in Research and Practice

et al. 2017

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Achieving and sustaining high levels of adherence to medication regimens is essential to improving health outcomes, but continues to be a challenge for a sizable proportion of patients. Decades of research suggests that medication adherence is determined by a complex constellation of factors. Social-behavioral science research has focused on creating frameworks that identify which contextual, personal, social, or drug-related factors appear to most influence adherence. Comprehensive models of adherence propose specific structural relationships between these factors that can be used to plan for, implement, and monitor programs that seek to optimize adherence. The use of social-behavioral models offers multiple advantages in both practice and research environments; however, the breadth and depth of these models can deter many from engaging in this important exercise. To promote the use of social-behavioral frameworks and models of adherence, we provide a brief overview of the advantages in using a social-behavioral lens in adherence work, a sampling of models used in HIV medication adherence research that have high generalizability to other conditions, and practical guidance for grounding adherence promotion strategies in evidence informed by social-behavioral science research.

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“…Rigorous research and in-depth review has been identified as a critical limiting factor to the development of much needed adherence-informed tools for health care professionals. 12 , 13 Relevant published literature broadly assigns methods for measuring adherence into two categories, direct and indirect, based upon mode of observation employed by each. To begin to distinguish relative value among many measures, Table 1 describes both direct and indirect measures and denotes advantages for each.…”

Section: Matching the Hammer To The Nail – Purposeful Measurementmentioning

confidence: 99%

Coming full circle in the measurement of medication adherence: opportunities and implications for health care

Buono¹,

Vrijens²,

Bosworth³

et al. 2017

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There is little debate that medication nonadherence is a major public health issue and that measuring nonadherence is a crucial step toward improving it. Moreover, while measuring adherence is becoming both more feasible and more common in the era of electronic information, the reliability and usefulness of various measurements of adherence have not been well established. This paper outlines the most commonly used measures of adherence and discusses the advantages and disadvantages of each that depend on the purpose for which the measure will be used. International consensus statements on definitions and guidelines for selection and use of medication adherence measures were reviewed. The quality of recommended measures was evaluated in selected publications from 2009 to 2014. The most robust medication adherence measures are often ill suited for large-scale use. Less robust measures were found to be commonly misapplied and subsequently misinterpreted in population-level analyses. Adherence assessment and measurement were rarely integrated into standard patient care practice patterns. Successful scalable and impactful strategies to improve medication adherence will depend on understanding how to efficiently and effectively measure adherence.

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A renewed Medication Adherence Alliance call to action: harnessing momentum to address medication nonadherence in the United States

Cited by 12 publications

References 33 publications

The availability of pharmacies in the United States: 2007–2015

The availability of pharmacies in the United States: 2007–2015

Advantages to Using Social-Behavioral Models of Medication Adherence in Research and Practice

Coming full circle in the measurement of medication adherence: opportunities and implications for health care

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