UM launches campaign on medication adherence in Baltimore

Months before U.S. Surgeon General Regina Benjamin, MD, MBA, came to Baltimore on Nov. 2 to officially launch the city's leg of a three-year national campaign to raise awareness about medication adherence, pharmacy students had already taken up the challenge, said Cherokee Layson-Wolf, PharmD, CGP, associate professor of pharmacy practice and science at the University of Maryland School of Pharmacy.

The School is part of a local coalition of Maryland-based health care stakeholders who gathered at the Maryland Science Center to kick off Baltimore's Script Your Future campaign, a program of the National Consumers League (NCL).

During October—American Pharmacists Month—School of Pharmacy students participated in a dozen events in the Baltimore region to promote proper medication adherence. They educated more than 2,000 people about the importance of the issue. "Our local efforts are aimed at raising awareness and making tools for adherence more accessible to consumers," said Layson-Wolf. Script Your Future tools include free text message reminders, sample questions for patients to ask health care practitioners, medication lists, condition management sheets, and fact sheets on common chronic conditions.

"All health care providers are part of the solution," Layson-Wolf explained. The pharmacy profession is "in an exceptional front line position to confront this issue" because pharmacists are among the most trusted resources for information related to medications, she said.

"In addition to our students' advance work on Script Your Future, they have spent thousands of hours each year educating patients on medication adherence and their disease states," Layson-Wolf said.

The School pairs students with patients in the community to teach the student how to communicate with the patients and develop a bond with them. The students learn about the barriers patients face in sticking to their medication regimes and by the time they are working pharmacists, said Layson-Wolf, each student has developed his or her own strategy to help patients deal with those barriers.

The urgency of the medication adherence issue dominated the Script Your Future launch event. Benjamin said, "Today, more than half of Americans suffer from at least one chronic illness such as diabetes, hypertension, or asthma, and that number is rapidly growing."

"Seventy-five percent of Americans don't take their medications as directed and that can cause serious consequences," said Benjamin. Because prevention is the "foundation of our public health system and the foundation of my career, our national challenge is to prevent poor health outcomes and to become a healthier and fit nation," she said.

Approximately 125,000 deaths every year are linked to patients who did not take their medication as directed, Benjamin told the more than 100 health care, business, and government professionals at the Script Your Future launch."

Layson-Wolf said non-adherence costs the U.S. health care system about $290 billion in avoidable costs annually. If the situation does not improve with Script Your Future and other resources, the figure will rise rapidly because of a projected 157 million Americans who will be affected by 2020 by one or more chronic conditions that require medication regimens.

Costs from people failing to take medications properly include, emergency room visits, hospital admissions, additional costs for medicines, and more health care providers, said Layson-Wolf.

New consumer surveys by the NCL show that patients who do not always take their medications as directed were less likely to have received a full explanation of consequences of their condition and are less convinced of the importance of adherence, said Rebecca Buckholder, NCL's vice president for health policy.

"Right now, conversations between patients and health care professionals aren't happening nearly as often as we would like them to be," added Oxiris Barbot, MD, Baltimore City Health Commissioner.

Benjamin added that chronic diseases can't be stopped. But the dire consequences of heart attacks, stroke, and even death can be prevented by getting people to take their medications properly.

Before the Baltimore launch of Script Your Future, pharmacy students at the University of Maryland took part in a Script Your Future adherence competition with 81 other U.S. pharmacy schools to help develop and implement the most effective adherence interventions in local communities.

The Baltimore Script Your Future coalition includes more than a dozen Baltimore-based health care stakeholders including the University of Maryland School of Pharmacy, the Maryland Pharmacists Association, and giant drug maker Pfizer Inc. Baltimore is one of only six cities selected by the NCL for participation.

"As we launch the campaign locally, the research reinforces the need to make medication adherence a priority in Baltimore, where 14 percent of residents are living with diabetes and 1 in 3 with high blood pressure," said Layson-Wolf.