Answer: D

“Medication non-adherence (statins)” is the major CMS Star Ratings issue related to AB’s care. Multiple approaches are applicable for this patient.  Since cost is a significant barrier to adherence for AB, utilizing a less expensive alternative can help improve access to medication. Once this initial critical barrier is addressed, AB can then be educated on the use and value of his cholesterol medication.  This can empower AB to be engaged in and a part of his own care. It is extremely important for patients to understand their medications and connect how their behaviors will impact their overall care and medication efficacy.

Reviewing how the medication works, how it should be taken, what to expect (benefit and risk), and what to monitor establish logical reasons for taking the medication correctly and potentially minimize the possibility of non-adherence.  For example, AB’s “as needed” impression of his cholesterol medication could be overcome simply by explaining how the medication works. These messages will then be reinforced by other healthcare providers, such as a pharmacist, to support AB as he transitions through each stage of his care. Finally, referring AB to a specialist, such as a nutritionist, can educate him on the value of proper nutrition and support him through a significant lifestyle change. Utilizing multiple approaches to managing AB’s care can address barriers and improve medication adherence.


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Lucio Volino, PharmD, is a Clinical Assistant Professor in the Ernest Mario School of Pharmacy at Rutgers, The State University of New Jersey in Piscataway, NJ.

References

1. Centers for Medicare and Medicaid Services. Medicare 2015 Part C & D Star Rating Technical Notes. Available from: https://www.cms.gov/medicare/prescription-drug-coverage/prescriptiondrugcovgenin/performancedata.html. Accessed October 16, 2015.