Another new year, another new year for Pharma to grasp the opportunity to work more closely with pharmacy to develop adherence enhancing activities that benefit patients, Pharma and pharmacists, but will it begin to happen in 2012?
Evidence suggest that the degree of historic involvement of Pharma with pharmacists to develop medicines adherence enhancing activities is patchy at best. There seems so far at least to have been a disbelief and distrust that pharmacists can and will actually give Pharma a return on their investment in adherence enhancing projects. Yet there is good evidence to suggest that well designed adherence enhancing activities, particularly those run run by pharmacists, can and do work. The government’s investment in MURs and in the New Medicines Service both suggest that the DOH at least believe that investing in pharmacy supported adherence enhancing activities is worthwhile, and historically the DOH have not had a reputation for funding pharmacy beyond the minimum required.
It seems to me that Pharma sadly now has quite a long history of having next to no meaningful relationships with pharmacists. The relationship has undoubtedly been made worse in recent times with the introduction by Pharma of DTP activities. Thus it is not perceived to be easy for Pharma to now begin to work closely with pharmacists. Yet there is no absolute bar to doing so and it is never too late to start. The ABPI are broadly supportive of pharmacist involvement in properly structured and professionally developed adherence development activities. When pharmacists have been given an opportunity to get involved in Pharma supported adherence enhancing activities that allows them to make good use their knowledge and skills, they have usually been very open to getting involved.
What has proved a turn-off for pharmacist involvement has been unmanageable bureaucracy that Pharma have required to track pharmacist participation ins such activities. What has also proved to be a negative to the success of adherence developing work has been the lack of clear and long term plans by Pharma to remain involved. Further, regular and ongoing communication channels need to be opened and maintained between Pharma and pharmacists involved in their adherence work for such co-operation to truly succeed.
Finally, I observe that adherence to medicine taking is a complex human psychological issue. Any initiatives developed by Pharma in adherence enhancement need to take full account of the patient’s perspective, as well as also fully considering:
Health-Care system & provider issues, the specific therapy, the specific condition, socio-economic factors and finally costs
My own organisation has been involved in some modest pilot project work in this area, and as a pharmacist myself, I have been able to act as a useful communication bridge between Pharma and community pharmacists.