Pharmacists are in a unique position to impact public health, one patient at a time. With more than 90% of Americans living within five miles of a community pharmacy, retail pharmacists often have multiple opportunities for patient engagement, with touchpoints ranging from vaccinations and point-of-care testing to prescription pickups and medication counseling.
Medication therapy management (MTM) is an area in which pharmacists can leverage their trusted role to support better outcomes. Research tells us that pharmacist counseling can improve patient adherence, yet low adherence rates have dogged healthcare for decades. Of the 3.8 billion prescriptions written in the United States per year, approximately 1 in 5 are never filled, and nonadherence costs the health care system between $100 and $300 billion annually.
Pharmacists need more tools in their belt to be as effective as possible in their interactions with patients when it comes to medication adherence. At Biologics by McKesson specialty pharmacy, our clinicians draw from multiple approaches to engage with patients, from conversation starters to risk-assessment questionnaires. One key tool that we are employing now is motivational interviewing—a collaborative conversation style designed to strengthen a person’s own motivation and commitment to change.
What is Motivational Interviewing (MI)?
MI is an evidence-based practice developed by psychologists in the 1980s, originally developed for people with alcohol and substance abuse. Based on the idea that behavior change is possible only when a person feels accepted and valued, MI has been shown to be successful in many different spaces, from smoking cessation and eating disorders to diabetes management.
Research supports the efficacy of MI in promoting medication compliance, including a randomized controlled study of 366 patients with multiple sclerosis, in which the intervention group received telephone counseling based on motivational interviewing.In that study, only 1.2% of patients in the intervention group discontinued the therapy, compared with 8.7% of patients in the standard care group who discontinued treatment.
Any medication-adherence intervention must begin with an understanding that every patient is unique and has different reasons to potentially become nonadherent. Factors impacting adherence can include the patient’s attitudes and beliefs, therapy-related reasons such as adverse effects, and socioeconomic or financial barriers. The beauty of MI is that it acknowledges and makes room for the personal and specific circumstances of every patient.
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