With research showing that the rate of adherence to mental-health prescriptions is lower than for drugs to treat other conditions, pharmacists are in a good position to support patients by optimizing medications and following up with them, says Allison Nourse, national director of pharmacy innovation at Pharmasave Drugs Ltd.

“This helps to improve outcomes and reduce costs,” she said during a session at the Pharmacy Solutions in Drug Plan Management forum in Mississauga, Ont., on Oct. 18.

As Nourse told the conference, studies indicate that while 77 per cent of individuals with depression or anxiety are in the workforce, 40 per cent of those working full-time are doing so at a reduced level of functioning.

One of the main reasons is a low level of adherence to psychiatric medications. As one study showed, more than half of patients discontinue anti-depressants after about two months.

“When medications aren’t taken as prescribed, it can lead to relapse of the initial condition they were being treated for. In turn, that can lead to less productive employees or even absenteeism from work. That leads to increased costs for employers and the health-care system,” said Nourse.

Factors affecting adherence often include a lack of awareness, denial of the illness, side-effects, complex drug regimens and costs.

Read: Conference coverage: Pharmacy Solutions in Drug Plan Management forum

Pharmacists, said Nourse, are in an ideal position to help patients optimize their mental-health medication and increase adherence.

“There are over 39,000 pharmacists in Canada in urban and rural areas. The average patient sees their pharmacist five to seven more times annually than their physician.”

Better adherence, she told attendees, starts with optimization and the proper management of medications. A medication review, for example, would explore whether a drug is necessary, safe, effective, affordable and easy to take.

Pharmacists can also educate plan members and make them part of the decision-making process, said Nourse.

“To ensure that a patient has the confidence and motivation to take their medications, they need to understand how they work and when they can expect to see symptom improvement.”

Other strategies involve making sure plan members are aware of side-effects and how to manage them; helping to find low-cost alternatives if the formulary is available; aligning the patient’s refill cycle; ensuring their medication regimen is simple; and the use of reminder tools.

Read: Pharmacists’ role evolving to help plans manage costs

Pharmacists may also be able to take advantage of advances in precision medicine using pharmacogenomics to reduce the risk of side-effects and achieve optimal therapeutic outcomes earlier, according to Nourse.

Several pharmacogenomic tests — which study the relationship between genetic variations and how the body responds to medications — are available in Canada but they differ in the medications they cover, cost and availability.

At the same time, Nourse said genetic testing alone can’t detect an optimal medication, suggesting the pharmacist plays a key role in assessing the whole picture to determine if a plan covers a drug, whether there are interactions and side-effects and if it’s easy to take.

Copyright © 2018 Transcontinental Media G.P. Originally published on benefitscanada.com

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