Improving Medication Adherence During a Pandemic BY D O R OT H Y LO C K H A R T, M B A , M S N , R N
When the COVID-19 pandemic arrived in Central Kentucky in March 2020, CHI Saint Joseph Health Partners (Health Partners) recognized the need to develop new strategies to make a difference in our populations. Like many areas of the country, provider offices temporarily closed, appointments were canceled, and patients postponed treatment and preventive screenings even after provider offices reopened. Health Partners leadership knew that a strategy focused on pharmacy quality measures would make an impact, even while patients were not accessing care from providers. As a care management team, we believed that medication adherence was paramount to keeping our patients out of emergency rooms and avoiding unnecessary hospital stays during the pandemic.
PARTNERING WITH PAYERS We began the effort by using data from contracted payers to identify patients who had failed the medication adherence measure the previous year or years. Once the current year data was available, our clinical pharmacist partnered with the payer’s clinical pharmacist to obtain medication reports for each Health Partners market. Once the patient was entered into the measure, the Health Partners clinical pharmacist was able to determine the last date that an intervention could make an impact before the patient would fail the measure for the current year. We then used these reports to monitor adherence on a monthly basis. The streamlined strategy was to first reach out to those identified patients— understanding that if a patient failed the measure in the previous year, he or she would likely fail the measure again. Regional market clinical directors disseminated the reports to our RN ambulatory care coordinators (RN ACCs) and ambulatory care assistants (ACAs).
PATIENT OUTREACH The assigned RN ACC or the ACA called all patients on the monthly list who had a “last impactable date” occurring that month. During these outreach calls, the RN ACC also addressed other quality measure needs, including diabetes control, A1C testing, and the importance of medication adherence. Staff acknowledged that patients may have previously failed the medication adherence measure due to social or economic barriers preventing them from accessing medications. If the patient was unable to obtain medication due to a social determinant of health, a referral was made to the Health Partners social work
22 l JOURNAL OF AMERICA’S PHYSICIAN GROUPS
Spring 2021
“Medication
adherence was paramount to keeping our patients out of emergency rooms and avoiding unnecessary hospital stays.”
