Supporting Adherence for Patients with MDD

Drs Weaver and Chitre share strategies to support MDD treatment adherence across their patient populations.

Jay Weaver, PharmD, MPH: Our plan has taken efforts to implement pharmaceutical care programs that seek to identify members with poor adherence through calculations, such as their MPRs [medication possession ratio] or PDCs [proportion of days covered], to say, “These look like folks who are at risk of not taking a medication enough to get efficacy.” We’ve created a set of cognitive services provided by nurses and pharmacists to do outreach to members who seem to be at risk. Or when a member is calling us around a particular concern that they have, such as about their medical benefits, we can flag that person. That way, when they call us, we can say, “We also have something to address about your medication. Can you speak to one of our nurses or pharmacists?” depending on the level of medication complexity we’re dealing with.

As you can imagine, nurses are very qualified to speak to people about their motivations of taking medication to clarify information about medications and all that. Those are great resources. They’re used to engaging members very often around these things. For very complex pharmaceutical issues—maybe the person has 5, 7, or 10 medications, and they aren’t sure which medications are causing a certain adverse effect, or they’re concerned about the cost—we have pharmacists available to help sort through drug regimen reviews and help solve those problems for them.

Mona Chitre, PharmD, CGP: We take a number of strategies to improve adherence. Our philosophy is to ensure we provide access to high-quality, affordable care for our communities. Specifically in the MDD [major depressive disorder] population, we work across the continuum across every stakeholder in health care to ensure adherence. We start with the members. We provide them support services and ensure they know what to expect from their health care system. They know the questions to ask and the outcomes they should expect.

We work with clinicians and provide data and information related to treatment options. We also work with them around specific data points that might be helpful. We work with our employers, ensuring that they provide access to critical components around the mental health spectrum and care delivery. Across our communities, we work to ensure there’s visibility to the services and programs we offer that can deliver on our goal: providing access to high-quality health care. We do this at the macro level from a data and population health perspective and then at the member level through care management outreach, pharmacy outreach, and awareness, where our providers and members know they can call us directly.

Transcript edited for clarity.

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