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AdhereHealth’s digital pharmacists leverage a variety of strategies to identify and address complex challenges that lead to medication non-adherence or potential drug safety problems. Here’s what it’s like to spend a day working directly with patients.
Pharmacists are some of the most important members of any patient’s care team. With extensive training in all aspects of medication dispensing and drug interactions, pharmacists are crucial for ensuring that individuals are taking their prescriptions in a safe, appropriate manner.
Unfortunately, not all patients have regular access to the skills and knowledge of an experienced pharmacist. Pharmacy deserts are common in rural and urban regions across the country, leaving some of the most vulnerable communities struggling to fill prescriptions and get help understanding their medication regimens.
That’s where digital pharmacists come in. By using the phone to conduct medication reviews and offer adherence coaching, digital pharmacists can reach more patients in need, close gaps in care, and provide a level of support that isn’t always feasible in traditional settings.
To learn more about what it’s like to be working in the pharmacy of the future, we spoke to Danielle Case, PharmD, Associate Vice President of Pharmacy Operations and Collegiate Partnerships at AdhereHealth. Case began her career at AdhereHealth as a front-line pharmacist before taking on a management role at the company.
Here are her thoughts about what it takes to be a digital pharmacist on a day-to-day basis and why it’s so critical for patients to have comprehensive, proactive, informed conversations about their clinical and non-clinical challenges.
What does an initial contact with a new patient look like? What are some of the objectives of that first conversation?
We receive patient information from their health plan. Then we perform proprietary analytics to prioritize those most at risk for nonadherence or drug therapy problems. That allows us to create an outreach process that ensures we’re connecting with everyone who might need support.
The initial appointment is all about making a personal connection with the patient. Those first conversations are so critically important, because we’ve found that more than 50 percent of these patients have a potential drug therapy problem that really needs to be addressed.
We take a lot of time to conduct these discussions – sometimes up to 20 minutes per patient – because they often reveal challenges that don’t get identified elsewhere. In a lot of healthcare settings, patients can feel rushed or anxious. And in traditional pharmacies, they’re not necessarily always getting the attention they need. Pharmacists are being pulled in so many different directions, especially now that they’re taking charge of the COVID vaccination process, and they don’t always have the time to sit down with every person to make sure all their medications are in order.
That’s why it’s really important to have AdhereHealth as that additional, dedicated resource that can build a meaningful and ongoing relationship and answer any of those questions that might have slipped through the cracks.
What’s the key to creating lasting positive behavior change in patients with complex clinical and non-clinical needs?
Education is a big part of what we do. Many people will stop taking a medication because they don’t feel any different – or maybe they do feel different in a bad way, and they don’t know that we can make adjustments or changes to prevent some of those adverse side effects. We start by breaking problems down into pieces and asking open-ended questions that prompt engagement.
Typically, these are people who are going through a lot in their lives, and they might be a little skeptical about what you’re doing at the start of the conversation. But if you’re empathetic, polite, and able to meet them where they are, most of the time they will start to open up and be willing to make a connection with you.
We don’t believe in one-and-done relationships. For someone who is non-adherent, for example, we’re going to be reaching out to them upwards of five times a year. We’re going to check in on them, continue to provide motivation and support for them, and answer any of their ongoing questions. That gives us so many opportunities to build rapport, get to know these patients as individuals, and create trust, which is the best foundation for making changes that stick around for the long term.
How do you address the social determinants of health and other barriers that might get in the way of optimal health for your patients?
The social determinants of health play a huge role in what we do. We use motivational interviewing techniques to uncover any barriers to adherence, whether that’s transportation to the pharmacy or the need to choose between buying groceries that week and affording their medications.
The first thing we do is educate them on any of the health plan benefits they might not be using, like mail order medication delivery. If they have additional socioeconomic needs, we’ll find local resources for them using platforms like findhelp.
A lot of times, they’re just out of refills and haven’t been able to connect with their provider to get a new prescription. We’ve seen this a lot during COVID: yearly checkups are being postponed, so patients don’t get to have that conversation with their primary care provider and maintenance medications fall by the wayside. That’s a fairly easy fix, but patients often need help getting it done.
In any of these situations, we don’t just leave them with a phone number and hope they call. We will always offer to keep them on the line while we call their primary care provider or call the community-based organization so that connection happens in real-time. If they don’t want to do that, we’ll still call their provider directly to secure a refill, and we’ll call their pharmacy to make sure the pharmacist knows to expect the prescription, too.
It’s incredibly important to close that loop, which is why we supplement these efforts with analytics in our platform to let us know that the services were successfully delivered or the medication was actually picked up.
What is your favorite part about being a digital pharmacist with AdhereHealth?
This is a role that is very challenging, but also very rewarding. You have to be able to make people feel comfortable over the phone, so you have to be a good listener and be genuinely empathetic. You also have to understand that you might get some pushback every now and again, so you need the skills to handle that appropriately.
The best part about being a digital pharmacist is the ability to work so closely with patients for so much of the day. You really get to know them and it’s extremely gratifying to solve for problems that might otherwise seem unsolvable.
One of my boss’s favorite stories is about a patient who wasn’t picking up their prescriptions because they were choosing between their medications or food for their dog. She actually called the helpline for the dog food manufacturer and was able to get some coupons that allowed the patient to afford both things. That’s such a creative solution to a problem that wouldn’t even be identified in some other clinical settings.
Being able to work with patients like that is what every clinician dreams about when they enter their field. Our focus on holistic and proactive patient care allows us to make the most of our skills and give every patient the attention and expertise they deserve.