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Quality Corner: Medication adherence tips from Pharmacy

Are you familiar with adherence measures and eager to ensure high-performance results? Improving patient outcomes and maintaining performance ratings through medication adherence is the ideal fusion between positive clinical outcomes and quality performance. Let’s delve into what adherence measures entail and explore some tips to guarantee your success.

CMS defines adherence through The Proportion of Days Covered (PDC), a metric that describes the percentage of available medication a patient has access to over a specified timeframe; 80% is the magic threshold for a patient to be considered adherent to their medication. We aim to target three distinct measures: Medication adherence to diabetes medications (MAD), medication adherence to cholesterol medications (MAC), and medication adherence to hypertension medications (MAH). These measures are triple-weighted, so ensuring that patients are adherent to medications within those drug classes helps to promote positive health outcomes for patients while simultaneously contributing substantially to your overall star ratings.

Here’s an organized approach to consider bearing these measures in mind:
  1. Ensure prescriptions are written as intended:
    • To reduce medication related errors, it’s always best practice to ensure our medication lists are as accurate as possible and ensure the payer sees the appropriate directions to calculate an accurate day supply on hand. If a medication dose is adjusted, send a new prescription with the correct instructions.
    • This can have a huge impact on the adherence measures performance and ensure the patient has the most up-to-date prescription on file with their pharmacy to avoid errors downstream.
  2. Consider writing 90– or 100– day supplies:
    • Many insurance plans offer medication discounts for 90- or 100-day supplies.
    • 90- and 100- day fills have consistently shown to improve trends in adherence.
    • They are convenient for the patient and free up your time from having to address more frequent refills.
  3. Proactively mitigate nonadherence with effective communication:
    • Ask open-ended questions during visits to identify and address patient-specific barriers to adherence.
A handout containing additional tips to encourage adherence is provided here as well. If you are interested in working more intimately with adherence measures, feel free to reach out to Julie Fong on our Quality Performance Improvement team who can provide targeted lists to work with. Together, we can enhance patient care and make strides towards improved medication adherence and overall health outcomes.