Pharmacy U

Use med reviews to build trust and prevent adherence issues


We spoke with Denis M. Roy, senior director of professional affairs with Pharmaprix/Shoppers Drug Mart in Montreal, about customer loyalty and adherence, the importance of both, and the building blocks of patient health outcomes in a successful pharmacy.


By donalee Moulton

How important is customer loyalty for pharmacies in Canada today?

Loyalty comes after a relationship of trust is established. In their landmark papers, Charles Hepler and Linda Strand identified that nothing can be accomplished until a therapeutic relationship is created and every thriving pharmacy understands the value of building customer trust.

The challenge is having the resources to create effective therapeutic bonds, day after day, in a transactional environment that is focused primarily on volume. Public and private payers reward activities and not patient outcomes. It has been challenging for pharmacists to create sustainable relationships using motivational interviewing techniques that allow for better adherence and outcomes. While additional Rx volume benefits a pharmacy that invests in adherence, this return is not big enough to fund all the resources required. The funding of medication reviews is needed to provide a ROI resulting in optimal drug use.

How can adherence be enhanced overall?

Adherence is a product of good medication therapy management. Drugs are not consumer goods. They generate optimal results when accompanied with “therapy” provided by the pharmacist. The value proposition for prescription drugs stems from both the “pharmaco” and the “therapy.” When providing therapy, the pharmacist looks for cues to patient concerns and health beliefs that may motivate patients not to take their medication. It’s this therapy component that ensures the adherence required to generate positive outcomes.

How important is adherence in advancing overall patient care?

Non-adherence is the biggest problem in chronic disease and the biggest source of preventable hospital admissions. Frankly, I am surprised some governments are making it more difficult to provide medication review services that prevent adherence issues.

Pharmacists need a conversation starter with patients to bring therapeutic goals to the forefront of their discussions. Loyalty points or wellness incentive programs that reward patients for taking action to improve their health may help them reach their therapeutic goals.

Do medication reviews help pharmacists build customer loyalty and enhance adherence?

Medication reviews provide the best opportunity for pharmacists to get a holistic view of patients, educate them and monitor adherence. Governments should reimburse medication reviews based on eligibility criteria including risks to adherence that comes with multiple refill due dates. A medication synchronization program that starts off with a short consultation has very positive impacts. Medication reviews provide the funding for resources to educate patients on the goals for each medication. This enhanced scrutiny, care, and active listening from pharmacists is an integral part of what is required to get more patients to reach targets known to prevent complications.

Adherence is one of the many challenges facing pharmacists today. What steps can be taken for improvements in this important area?

Medication synchronization is important, but it is not enough on its own. You also need to educate patients and ask them for feedback. That way you can identify the issues that affect adherence. The consultation required to set up the appointment-based model generates most of the value. This type of medication review is one of the most promising, cost-effective activities for the sustainability of our healthcare system.

Leaders in Pharmacy, including this independently written article, is supported by Pfizer Canada.