ADHERENCE

Medication adherence is generally defined as the patient’s conformance with the provider’s recommendation with respect to timing, dosage, and frequency of medication taking during the prescribed length of time. Patients are generally considered adherent to their medication if their Proportion of Days Covered (PDC) is equal to or greater than 0.8 (or 80%). Eighty percent is the goal for patients on most classes of chronic medications (antiretrovirals for HIV/AIDS and some cancer oral therapies have an approx. 0.95 or 95% threshold). 

RECONCILIATION

Medication reconciliation is the process of identifying errors and acting on discrepancies in patients’ medication histories by obtaining and maintaining accurate and complete medication information for a patient and using this information to ensure safe and effective medication use. Medication reconciliation is a key aspect of patient safety, as it promotes the focus for providers and patients to verify patient medication lists at key transition points to identify which medications have been added, discontinued, or changed, compared to pre-admission medication lists. 

ENGAGEMENT & EDUCATION

Patient and family engagement strategies have shown such promise that they have been incorporated into the majority of recent efforts to improve healthcare quality. CMS describes patients and their families as essential partners in the effort to improve the quality and safety of health care.
With the focus on healthcare value, patient engagement and education has gained increased prominence and is recognized as a crucial component of high-quality healthcare services and better patient outcomes. Patient engagement is also a critical procurer to successfully educating patients about their medications. When patients are engaged, they are more likely to understand what is being taught about their medications and ask questions when they do not.

AFFORDABILITY

Prescription drugs play a critical role in helping to prevent, manage, and cure disease, yet they are a key factor pushing up healthcare costs. While the rate of growth of health spending in the US continues to increase, the rate of prescription drug spending has far outpaced healthcare spending.  According to the IQVIA, the rapid growth in drug costs over the last decade has been primarily due to increased spending for new medications, especially specialty drugs used to treat complicated conditions like cancer, rare conditions, and rheumatoid arthritis.

This rapid growth in prescription medication prices over the last few years has become a national issue and the subject of a number of congressional hearings and probes. 

SAFE MEDICATION USE

In the IOM “To Err Is Human: Building a Safer Health System” report, medication-related errors were a significant cause of morbidity and mortality as they accounted for at least 1.5 million medication-related events, or preventable medication related injuries that occur yearly in the US. Medication errors have been estimated to account for 1.9 million hospital stays, increased length of hospital stays, the most common causes of inpatient complications, and about $3.5 billion in hospital costs. In outpatient/ambulatory settings, medication errors are the most common post discharge complication, resulting in 3.5 million office/ambulatory visits, and 1 million emergency department visits. 
Medication errors also account for one out of every 131 outpatient deaths, and one out of 854 inpatient deaths, totaling more than 7,000 deaths annually. Based on these and other findings, the IOM issued a report in 2007 on medication safety called “Preventing Medication Errors.” This report focused on many issues including the importance of reducing medication errors, providing clinicians with information and decision-support tools, and processes to reduce medication errors and adverse outcomes.