May 15, 2023 • 25 mins
Medication adherence refers to taking prescription medicine correctly as prescribed. In this episode of the Community Check-In, Dr. Mona Chitre, chief pharmacy officer and president of pharmacy solutions at Excellus BlueCross BlueShield discusses the importance of medication adherence as well as how to save money on prescription medications. According to the Centers for Disease Control and Prevention (CDC), at any given time, half of all patients are not taking their medications as prescribed. Are you?
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(00:03):
Welcome to excel Us Blue Cross BlueShields Community check In. Each week we
cover a specific topic featuring excel UsBlue Cross Blue Shield experts. You'll get
to know our team as we discussthe latest in healthcare, health education,
and community health. Find us atexcel Us BCBS dot com and follow on
(00:25):
Instagram and Facebook. I'm Joelomonico andwelcome to the check in. I take
prescription medications every day, My wifedoes too. Many of our friends do
you probably do as well. Thisweek, our guest is doctor Mona Chitra,
who's the Chief Pharmacy Officer and Presidentof Pharmacy Solutions at excel Us Blue
(00:46):
Cross Blue Shield and we're going tobe talking about the importance of taking your
medications correctly, as it's a vitallyimportant part of the health and safety of
our community members. Doctor Chitra,welcome to the Community check In. It's
nice to have you. How greatto be here, Joe. As I
mentioned, doctor Chitra is a doctorof pharmacy and the chief Pharmacy Officer and
(01:06):
President of Pharmacy Solutions that excel AsBlue Cross Blue Shield. She's a national
thought leader in the pharmacy marketplace andhas held leadership roles in pharmacy, medical
programs, and clinical policy development.The doctor is leading strategies that drive affordability,
innovation, and access to care forall members across commercial Safety Net and
(01:29):
Medicare lines of business. Doctor Chitreis a twenty twenty two Rochester Business Journal
Circle of Excellence honoree and was arecent finalist for the Athena International Awards.
And we're going to get started bytalking really about discussing something you call medication
adherents. So what I want todo to start off with is to help
our audience understand exactly what that means. Thanks Joe. So, medication adherence
(01:56):
means taking your medication exactly as directedby your doctor or other medical provider.
We know that medications can't work tomake you healthier if they are not taken
as intended. And Joe, youlet off with We, our friends,
our family take medication, and it'snot easy always to take medications as prescribed.
(02:17):
So if there's some interesting statistics,if there are, you know,
a hundred prescriptions that are our dispenseor written by a doctor, only about
a half are filled. Of thoseonly a half less than a half of
those are even taken, and fewerof those are refilled. And if you
(02:38):
don't take your medication as prescribed,and what that means again, medication adherence
means taking it exactly the way yourdoctor told you to take it, so
not a little less, not everyother day, not stopping because you feel
better, but exactly as prescribed.And there's a lot of value to that.
(03:00):
So if we're not taking the medicationsas prescribed and you go back to
the doctor, they might think,wow, you know your medication is not
working, and you may have moremedications than to deal with changes of doses,
etc. Etc. So it's areally really important topic and I'm so
thankful we're talking about it today.Where do you think, doctor, the
(03:20):
disconnect is between patients and prescribers whenit comes to I mean, those numbers
are quite surprising from those estimates yougave us, and we're sort of looking
at a sort of a general rule, but it seems to me that there's
some sort of a break between howa patient understands what their role in their
healthcare is and how a prescriber isthen going to help them understand what the
(03:44):
importance is, how to do itand sort of guiding them along. Yeah,
there's so many factors at play,so we can kind of think of
them in different ways. The firstis some of our chronic conditions, the
diabetes, high blood pressure, highcholesterol. We call them silent. You
don't feel sick, you don't reallyeven believe you have a condition or you
(04:04):
need a medication. So when youprescribe that medication, sometimes you know you
might have a side effect, youmight feel a little bit different than you
did before you started the medication.That's where we see a disconnect, you
know. One example is I'm feelingworse on the medication than I was with
the condition, And it goes backto knowing your goals. It goes back
(04:26):
to having that conversation. And Ithink, Joe, that's the most important
part. How do we eliminate orreduce that disconnect? Ask questions, why
are you prescribing me this medication?What exactly is the consequence of my disease?
What can it do to me?When you have diabetes, or sometimes
called a touch of sugar, thereare a lot of downstream complications, including
(04:48):
stroke, including heart attack, includingamputations. So really just having an open
conversation with your doctor, with yourpharmacist on why the medication has been prescribed,
and then ensuring you know, youhave some tips of how to stay
on the medication exactly. Have thoseopen conversations about what is this medication doing
(05:12):
for me, how is it supposedto work? You know, maybe you
want to know these things. Aninformed patient is a great patient when it
comes to building that relationship. Nowlet's talk about the other side of this.
You have a prescription medication, andyou alluded to it a little bit
earlier. If you don't take thatas prescribed as directed, you can then
go back to your doctor, andyour doctor potentially doesn't have the full picture
(05:36):
of your health because they might notknow or you might, as a patient,
might not tell them exactly what's goingon in your day to day.
Yeah. Absolutely, and that justadds to the complication and the complexity of
more non adherents and perhaps more medicationsbeing dispensed and more side effects and more
cost So really the best thing todo, and it's been clinically proven that
(06:00):
first medication taken as directed is oneof the most important things you can do
to manage your health. And alsoknowing, as you mentioned earlier, there
may be side effects you may feelworse when you're on a medication. You
may experience something you hadn't anticipated.It's going maybe back to your doctor to
say, I need to just talkabout this. What's happening to me?
(06:21):
Do we need to make an adjustment? Do we need to try a different
medication. Not just saying well,I'm not going to take this right now
and putting it up on a shelfand forgetting about it. Ask questions,
share what's happening. And you haveyour physician, your doctor. You also
have pharmacists, pharmacists in the retailyou at your local retailer are available to
(06:45):
answer these questions, and you know, putting it on the shelf until your
next visit. There's so many thingsthat can be done, Joe, Just
like you mentioned, for example,there could be a slight reduction in dose
until your body can get used toit. They can change the time of
day for medication if it makes youdrowsey, you take it at night.
As an example, there are medicationsin the same category that you know.
(07:08):
Some have a cough side effect,some don't. It really depends on the
patient. Some you can take withfood. So there's so many solutions for
our community. Our members taking medicationthat can help solve for those side effects
or those whatever they may be feelingwhen they start these medications. I think
(07:30):
perhaps, and maybe you've seen thisin your work in practices, that maybe
someone thinks that as soon as Itake a medication, it's supposed to just
be that magic pill, and you'regiving me this pill because it's supposed to
help whatever I happen to have beendiagnosed with or whatever I'm working with,
and if it deviates slightly, maybethat's a mental issue on the part of
(07:51):
ours, ourselves who take these medications, that if it's if it tends to
go out of our expectation range,then we just think something's wrong and maybe
we'll be immediately resistant to it orjust decide I'm going to treat myself now
instead of listening to my physicians direction. Yeah, I think there's so much
of that. Right. So,when you take an antibiotic, sometimes you
(08:13):
feel better by day three, andyou have seven days of pills. You
take them all so right, youtake them all? Why because you might
feel better, but you still havebacteria. And if you don't fully get
rid of that bacteria, then allof a sudden that antibiotic is not going
to work for the future. Sothere's that. Then there's those that I
don't feel sick, Why am Ieven getting a prescription and don't feel sick,
(08:35):
and again really understanding what those prescriptionsare for. Then there's the cost
issue. Times are tough, gasis expensive, things are expensive, and
if I don't if I'm not reallysure why I'm on this medication, maybe
I won't take it. But pleasenote that every medication being prescribed has an
(08:58):
intended effect. It has no factintended effect to manage and improve your quality
of life, your disease, yourcondition. So I always keep that in
the back back of your head asto why it was prescribed, and there's
a reason it was prescribed. DoctorMonachitre is our guest on the Community check
in this week. She's the chiefpharmacy Officer and president of Pharmacy Solutions that
(09:18):
Excels Blue Cross, Blue Shield,and we're talking about medication adherents. That
is a fancy term for talking takingyour prescription medication as directed and prescribed by
your doctor. Here's something I foundinteresting. The National Institute of Health says
that non adherents could result in asmuch as a hundred thousand preventable deaths every
year in the United States. Whenyou talk about cost too, there's a
(09:41):
huge cost in human life, buta financial impact as well, one hundred
billion dollars a year in preventable medicalcost. Something as simple as taking a
pill every day or however it isprescribed by your physician can have a dramatic
impact on the entire community, notyou as a part of it. Yeah.
(10:01):
Absolutely, this is just as muchof an issue as it's almost as
important as the pandemic. You know, it is so critical, it is
so vital to all of our communitymembers taking medications to take it. Take
these medications as prescribed again, heartattack, stroke, amputation, blindness,
(10:22):
these are all preventable if for achronic condition, you take your medications as
prescribed, You follow what your providers, your doctors have told you to do,
and it can have a snowball effectand impact things that are you might
not even think of them, butoverall it can just keep going and going
and going. Doctor. What aresome of those other common mistakes. I
(10:43):
want to take a little more timewith this, These common mistakes that you
see and have seen when it comesto people just being able to take those
medications as directed. Yeah, sothe first one I'll say is about the
perception of the medication. I don'tneed it. Why am I on it?
I don't feel sick. I canmanage. And one of the key
(11:07):
I think items we've already talked aboutis having that open conversation. Really,
it's okay to ask I don't understand, why help me again, you know,
explain to me how this medication willwork. We want to make sure
that you know, any person ona medication knows why they're on it.
(11:28):
I get it. It makes sense. It's something that you're taking in you
know you're taking. You should understandwhy you're on it. So that's really
don't be afraid to ask questions.If you can't get in touch with your
provider, ask your pharmacist. Thereare healthcare providers pharmacists available. You're a
doctor their office that can always helpyou with those questions. So perception is
(11:52):
to me kind of one of thebig ones. Again, I feel better
my antibiotic. I've been on it. Now I feel better. I'm gonna
stop taking it. So people justsometimes feel better, which is great,
but that does not mean you don'tfinish the course of therapy. Second and
third we talked about this is thosesilent diseases, the diseases like diabetes and
(12:13):
high cholesterol, those diseases where oftenyou don't feel sick and you forget,
you just forget to take your medication. Sometimes you're on two, three,
four different medications and it's tiresome,it's burdensome, but please remember it's so
important to your health. And thenreally, ultimately it goes back. I
(12:33):
guess there's a few other things wetalked about this side effects. I don't
feel great on medications sometimes, butthere are so many options available so that
we can get the majority of peopleon the right regimen. Sometimes it's hard
to follow up with your doctor,don't have time, So please know we
have telemedicine available and most physicians officesnow have telemedicine available. And of course
(12:56):
there's always that pharmacist at the retailstore to go to. And also cost
cost is an issue, especially whenyou're on a number of different medications.
So there's options there. You know, there's generics, there's combination drugs to
medications in one pill, there's homedelivery, and then we also have a
(13:16):
discount card available on our website.We can talk about later. So those
are the most common, you know, five or six reasons I hear of
why you know medication non adherents occurs. And I want to talk just a
little bit about that relationship with thepharmacist as well, because for some people
that can be a more immediate pointof contact. And you've spent a fair
(13:39):
amount of time working with as chiefpharmacy officer, working in that capacity and
working with those professionals, sometimes youmight have a better relationship with that pharmacist
and might feel a bit more comfortableasking an initial question there and then take
it to your physician and have amore detailed conversation. I think that's a
(14:00):
great piece of advice that you giveto use the resources that are available sometimes
for people as soon as they walkinto the grocery store, absolutely and they're
they're available, they're accessible and happyto answer those drug related questions. They
want to provide this service to you. They want to make sure that you're
doing the best that you can tohave the best quality of life that you
(14:24):
can. And you know, sometimesif people feel like they're having those prescription
issues, I have a side effect. I wasn't expecting I don't like the
way I feel. I feel fine. Let's talk about some best practices that
we in the community can can startto just think about and remember, sort
of like next steps. It's like, okay, you do get that side
effect, Well what do you dofirst? What's the what's a step that
(14:46):
you're going to take instead of justsaying, well, I'm just not going
to take this anymore. Yeah,the first thing I would do is call
your physician or pharmacist and explain whatare you feeling and talk through could it
be a temper effect, side effect? Can it be solved by changing the
time of day, taking with food, etc. Etc. So that conversation,
(15:07):
that first conversation is so critical.Don't let it linger. Don't let
it become so burdensome you can't eventhink about taking that pill again. Have
the conversation. I think that isone of the most important things, is
being just open and honest of theimpact of this medication on your health,
because it was prescribed to make youfeel better, to improve your quality of
(15:31):
life over the long term. Soany any questions you have or side effects
you may be going through, makethat phone call. Do you think that
some people avoid asking the questions justout of playing fear. I think it's
could be fear. It could beI don't want to be a bother.
It could be I don't want tobe an outlier. So yeah, fear
(15:54):
is probably something you know, notknowing there's seven different options that could be
taken, and this one, youknow, if it doesn't work for me,
oh my gosh, there's no otheroptions. So yeah, I think
there's all of all of that anxiety, fear, concern when that first medication
might not feel the way it shouldfeel. And you mentioned it before,
(16:15):
and I want to come back toit in a bit more length. As
about cost, prescription medications can oftenbe very expensive, and that can be
something that a community member would lookat and go, I can't. I
know my doctor's telling me that thisis going to be the right thing for
me, but I just I'm goingto have to sacrifice or not do something
(16:37):
else, or not do other thingsthat are important to the quality of my
life in order to take this medication. So I'm just going to say,
no, I can't do that.And there are options, as you mentioned,
there may be plenty of options thatthe community doesn't even know exist.
So yes, absolutely, cost isimportant. We are hearing this every single
day from our friends and family andpeople in our community. So the first
(17:02):
is, if you have health insurance, be sure to understand what's covered in
under your insurance benefit. Often thereare preferred pharmacies. There are benefits of
using home delivery, so call yourcustomer service line if you need more information,
and the one eight hundred number isright on your card, so feel
free to use it and ask anyquestions you may have. In addition,
(17:29):
we do also and many pharmacies offerdiscount cards. So if someone is currently
paying full price for certain prescription medicationsoutside of their pharmacy plan, they may
be able to access savings by usingour discount card which is called inside our
Ex Prescription Discount Card. It's aprescription savings program that offers savings on thousands
(17:53):
of brand name and generic medications andmore than sixty thousand anticipating pharmacies. And
you know you can compare and shoparea pharmacies and download the discount card by
visiting inside rx dot com forward slashex and there's no it's free to use
(18:14):
it, there's no enrollment, freeand you can really decide what's best for
you, right, you can sortof look at the look at your options
there and say do I use it? Do I not use it. It's
really about being as savvy as youcan as a consumer. Absolutely helps provide
additional piece of information and as I'mmaking yeah, and as I'm looking here,
this could be a substantial resource thatthe community can take advantage of.
(18:37):
The inside RX, it's a prescriptionsavings program that can in some cases offer
some substantial savings on both name brandand generic medications. And the participation that's
available within this pharmacy network is quitesubstantial, so it's probably wouldn't be like,
(18:57):
oh, my pharmacy might not participate. There's a pretty good chance that
if you're using a pharmacy in yourcommunity, it's probably a part of this
network. Here, I would sayabsolutely yes, over sixty thousand pharmacies are
participating and it is absolutely something thatcan be considered if cost is a barrier,
(19:22):
but there's a lot of again,call your health insurance company, understand
your copays, understand your benefits,and of course there's this discount card.
Doctor Monachitre is the chief pharmacy officerat Exceli's Blue Cross, Blue Shield we're
talking about something they call medication adherents. We want you to just remember it's
about if you're on a prescription medication, it's about following those instructions and about
(19:47):
taking it as directed, as prescribed. So what we're going to do in
our last few minutes is really we'regoing to go through some best steps for
you, and we're going to talkreally some specifics about how to help you
will take their medications properly. Let'sstart off with something simple. I arrange
my pills in one of those littleboxes that says that has a letter for
(20:08):
every day of the week, andthat for me is helpful enough. It
just makes sure that I can lookat that box and say did I take
them? Did I not take them? And if I didn't, I do
so. For some people, arrangementis something that could be the first step
they can take instead of having pillbottleseverywhere absolutely and even before that, Joe
(20:30):
is perhaps home delivery and automatic refallreminders, someone reminding you to pick up
your medication or being delivered straight toyour home and then you put it right
in that pillbox so you remember everyday. I love the auto refills,
I love the text messages that Iget that remind me, hey, it's
time to do it again, becauseyou know you'll do you lose track of
(20:51):
time sometime. And auto refills mailorders. All these types of things are
just resources that are available, reallydoctor to make things simple or the consumer
at the end of the day,that's really what it is. If you're
the patient, if you're taking it, you have to have things kind of
made a little easy, and theresources are there. Absolutely, that's that's
(21:11):
the goal. Keep it as simpleas possible. Recognizing you know, healthcare
is complex, so how do weensure our goal? Our collective goal is
to you know, get you totake your medication as prescribed so you have
the best quality of life and outcomethat you can exactly take them. Use
(21:33):
a calendar if you're if you're linkedto your phone, put an alarm on
your phone and label it so thatyou tells you what it is. Make
it part of your routine, Makeit part of your I take these with
breakfast, I take these with thedinner. These are the last thing I
take before I go to bed atnight, so that it's right there on
the bedside table. There are verysimple things, and I think sometimes maybe
(21:56):
we think doctor, that medications areare just not something that we're going to
integrate into our lives. They're alwayssort of standing separate. But maybe if
we shift the perspective on it alittle bit and make them just another part
of the every day when we dohave to take them, if there for
our benefit that just doing those simplethings can make adherence to taking your medication
(22:21):
a far simpler thing to achieve,Great, Joe, integrated part of your
life. And let's just talk aboutin our last two minutes here about the
resources that are available through excelis BlueCross, Blue Shield for members and non
members. It's a great resource thatyou can just go online and find some
of this stuff if you didn't happento take notes, or maybe you want
(22:42):
to hear something or see something again. The website does provide some incredible resources.
Yes, absolutely tips on how totake your medications, how to stay
adherent, some of the tips,Joe that you have already mentioned, and
of course that discount card is availableto every member in our community at no
(23:04):
charge inside RX dot com Forward SlashCapital exc and our goal is to make
this simpler and easier, all right, it's our final sixty seconds doctor,
So I'm going to give you theplatform to make your pitch to everyone out
in the audience there today about theimportance of if you are if you are
(23:29):
given a prescription medication, the importanceof following those directions and having open conversation
with your doctor to make sure thatyou have a great understanding of why you're
taking these drugs and really what todo if they don't seem to be doing
anything for you. Yeah, youknow, at the end of the day,
(23:49):
medications can't work if you don't takethem, and we know they work.
They've been studied and approved because theyshow benefit. So if you are
hesitant, if you can't remember,or if you have a side effect,
have a conversation. You have resourcesright here in the community, your provider,
(24:12):
your doctor, your telemedicine pharmacists,as well as the plan and we
can help collectively improve the outcomes forour community and ensure everyone is healthy and
safe. Doctor Monachitre, who's theChief Pharmacy Officer and President of Pharmacy Solutions
at Excelis Blue Cross Blue Shield,thanks for being a part of the check
(24:33):
in this week. Thanks for joiningus on community check in. A presentation
of excellis Blue Cross, Blue Shieldat iHeartRadio. Podcasts of community check in
are available on the iHeartRadio app orwherever you find your favorite audio content.
For more ways to stay safe,healthy, and educated, visit excelis bcbs
(24:55):
dot com and follow on Instagram andFacebook
Welcome to excel Us Blue Cross BlueShields Community check In. Each week we
cover a specific topic featuring excel UsBlue Cross Blue Shield experts. You'll get
to know our team as we discussthe latest in healthcare, health education,
and community health. Find us atexcel Us BCBS dot com and follow on
(00:25):
Instagram and Facebook. I'm Joelomonico andwelcome to the check in. I take
prescription medications every day, My wifedoes too. Many of our friends do
you probably do as well. Thisweek, our guest is doctor Mona Chitra,
who's the Chief Pharmacy Officer and Presidentof Pharmacy Solutions at excel Us Blue
(00:46):
Cross Blue Shield and we're going tobe talking about the importance of taking your
medications correctly, as it's a vitallyimportant part of the health and safety of
our community members. Doctor Chitra,welcome to the Community check In. It's
nice to have you. How greatto be here, Joe. As I
mentioned, doctor Chitra is a doctorof pharmacy and the chief Pharmacy Officer and
(01:06):
President of Pharmacy Solutions that excel AsBlue Cross Blue Shield. She's a national
thought leader in the pharmacy marketplace andhas held leadership roles in pharmacy, medical
programs, and clinical policy development.The doctor is leading strategies that drive affordability,
innovation, and access to care forall members across commercial Safety Net and
(01:29):
Medicare lines of business. Doctor Chitreis a twenty twenty two Rochester Business Journal
Circle of Excellence honoree and was arecent finalist for the Athena International Awards.
And we're going to get started bytalking really about discussing something you call medication
adherents. So what I want todo to start off with is to help
our audience understand exactly what that means. Thanks Joe. So, medication adherence
(01:56):
means taking your medication exactly as directedby your doctor or other medical provider.
We know that medications can't work tomake you healthier if they are not taken
as intended. And Joe, youlet off with We, our friends,
our family take medication, and it'snot easy always to take medications as prescribed.
(02:17):
So if there's some interesting statistics,if there are, you know,
a hundred prescriptions that are our dispenseor written by a doctor, only about
a half are filled. Of thoseonly a half less than a half of
those are even taken, and fewerof those are refilled. And if you
(02:38):
don't take your medication as prescribed,and what that means again, medication adherence
means taking it exactly the way yourdoctor told you to take it, so
not a little less, not everyother day, not stopping because you feel
better, but exactly as prescribed.And there's a lot of value to that.
(03:00):
So if we're not taking the medicationsas prescribed and you go back to
the doctor, they might think,wow, you know your medication is not
working, and you may have moremedications than to deal with changes of doses,
etc. Etc. So it's areally really important topic and I'm so
thankful we're talking about it today.Where do you think, doctor, the
(03:20):
disconnect is between patients and prescribers whenit comes to I mean, those numbers
are quite surprising from those estimates yougave us, and we're sort of looking
at a sort of a general rule, but it seems to me that there's
some sort of a break between howa patient understands what their role in their
healthcare is and how a prescriber isthen going to help them understand what the
(03:44):
importance is, how to do itand sort of guiding them along. Yeah,
there's so many factors at play,so we can kind of think of
them in different ways. The firstis some of our chronic conditions, the
diabetes, high blood pressure, highcholesterol. We call them silent. You
don't feel sick, you don't reallyeven believe you have a condition or you
(04:04):
need a medication. So when youprescribe that medication, sometimes you know you
might have a side effect, youmight feel a little bit different than you
did before you started the medication.That's where we see a disconnect, you
know. One example is I'm feelingworse on the medication than I was with
the condition, And it goes backto knowing your goals. It goes back
(04:26):
to having that conversation. And Ithink, Joe, that's the most important
part. How do we eliminate orreduce that disconnect? Ask questions, why
are you prescribing me this medication?What exactly is the consequence of my disease?
What can it do to me?When you have diabetes, or sometimes
called a touch of sugar, thereare a lot of downstream complications, including
(04:48):
stroke, including heart attack, includingamputations. So really just having an open
conversation with your doctor, with yourpharmacist on why the medication has been prescribed,
and then ensuring you know, youhave some tips of how to stay
on the medication exactly. Have thoseopen conversations about what is this medication doing
(05:12):
for me, how is it supposedto work? You know, maybe you
want to know these things. Aninformed patient is a great patient when it
comes to building that relationship. Nowlet's talk about the other side of this.
You have a prescription medication, andyou alluded to it a little bit
earlier. If you don't take thatas prescribed as directed, you can then
go back to your doctor, andyour doctor potentially doesn't have the full picture
(05:36):
of your health because they might notknow or you might, as a patient,
might not tell them exactly what's goingon in your day to day.
Yeah. Absolutely, and that justadds to the complication and the complexity of
more non adherents and perhaps more medicationsbeing dispensed and more side effects and more
cost So really the best thing todo, and it's been clinically proven that
(06:00):
first medication taken as directed is oneof the most important things you can do
to manage your health. And alsoknowing, as you mentioned earlier, there
may be side effects you may feelworse when you're on a medication. You
may experience something you hadn't anticipated.It's going maybe back to your doctor to
say, I need to just talkabout this. What's happening to me?
(06:21):
Do we need to make an adjustment? Do we need to try a different
medication. Not just saying well,I'm not going to take this right now
and putting it up on a shelfand forgetting about it. Ask questions,
share what's happening. And you haveyour physician, your doctor. You also
have pharmacists, pharmacists in the retailyou at your local retailer are available to
(06:45):
answer these questions, and you know, putting it on the shelf until your
next visit. There's so many thingsthat can be done, Joe, Just
like you mentioned, for example,there could be a slight reduction in dose
until your body can get used toit. They can change the time of
day for medication if it makes youdrowsey, you take it at night.
As an example, there are medicationsin the same category that you know.
(07:08):
Some have a cough side effect,some don't. It really depends on the
patient. Some you can take withfood. So there's so many solutions for
our community. Our members taking medicationthat can help solve for those side effects
or those whatever they may be feelingwhen they start these medications. I think
(07:30):
perhaps, and maybe you've seen thisin your work in practices, that maybe
someone thinks that as soon as Itake a medication, it's supposed to just
be that magic pill, and you'regiving me this pill because it's supposed to
help whatever I happen to have beendiagnosed with or whatever I'm working with,
and if it deviates slightly, maybethat's a mental issue on the part of
(07:51):
ours, ourselves who take these medications, that if it's if it tends to
go out of our expectation range,then we just think something's wrong and maybe
we'll be immediately resistant to it orjust decide I'm going to treat myself now
instead of listening to my physicians direction. Yeah, I think there's so much
of that. Right. So,when you take an antibiotic, sometimes you
(08:13):
feel better by day three, andyou have seven days of pills. You
take them all so right, youtake them all? Why because you might
feel better, but you still havebacteria. And if you don't fully get
rid of that bacteria, then allof a sudden that antibiotic is not going
to work for the future. Sothere's that. Then there's those that I
don't feel sick, Why am Ieven getting a prescription and don't feel sick,
(08:35):
and again really understanding what those prescriptionsare for. Then there's the cost
issue. Times are tough, gasis expensive, things are expensive, and
if I don't if I'm not reallysure why I'm on this medication, maybe
I won't take it. But pleasenote that every medication being prescribed has an
(08:58):
intended effect. It has no factintended effect to manage and improve your quality
of life, your disease, yourcondition. So I always keep that in
the back back of your head asto why it was prescribed, and there's
a reason it was prescribed. DoctorMonachitre is our guest on the Community check
in this week. She's the chiefpharmacy Officer and president of Pharmacy Solutions that
(09:18):
Excels Blue Cross, Blue Shield,and we're talking about medication adherents. That
is a fancy term for talking takingyour prescription medication as directed and prescribed by
your doctor. Here's something I foundinteresting. The National Institute of Health says
that non adherents could result in asmuch as a hundred thousand preventable deaths every
year in the United States. Whenyou talk about cost too, there's a
(09:41):
huge cost in human life, buta financial impact as well, one hundred
billion dollars a year in preventable medicalcost. Something as simple as taking a
pill every day or however it isprescribed by your physician can have a dramatic
impact on the entire community, notyou as a part of it. Yeah.
(10:01):
Absolutely, this is just as muchof an issue as it's almost as
important as the pandemic. You know, it is so critical, it is
so vital to all of our communitymembers taking medications to take it. Take
these medications as prescribed again, heartattack, stroke, amputation, blindness,
(10:22):
these are all preventable if for achronic condition, you take your medications as
prescribed, You follow what your providers, your doctors have told you to do,
and it can have a snowball effectand impact things that are you might
not even think of them, butoverall it can just keep going and going
and going. Doctor. What aresome of those other common mistakes. I
(10:43):
want to take a little more timewith this, These common mistakes that you
see and have seen when it comesto people just being able to take those
medications as directed. Yeah, sothe first one I'll say is about the
perception of the medication. I don'tneed it. Why am I on it?
I don't feel sick. I canmanage. And one of the key
(11:07):
I think items we've already talked aboutis having that open conversation. Really,
it's okay to ask I don't understand, why help me again, you know,
explain to me how this medication willwork. We want to make sure
that you know, any person ona medication knows why they're on it.
(11:28):
I get it. It makes sense. It's something that you're taking in you
know you're taking. You should understandwhy you're on it. So that's really
don't be afraid to ask questions.If you can't get in touch with your
provider, ask your pharmacist. Thereare healthcare providers pharmacists available. You're a
doctor their office that can always helpyou with those questions. So perception is
(11:52):
to me kind of one of thebig ones. Again, I feel better
my antibiotic. I've been on it. Now I feel better. I'm gonna
stop taking it. So people justsometimes feel better, which is great,
but that does not mean you don'tfinish the course of therapy. Second and
third we talked about this is thosesilent diseases, the diseases like diabetes and
(12:13):
high cholesterol, those diseases where oftenyou don't feel sick and you forget,
you just forget to take your medication. Sometimes you're on two, three,
four different medications and it's tiresome,it's burdensome, but please remember it's so
important to your health. And thenreally, ultimately it goes back. I
(12:33):
guess there's a few other things wetalked about this side effects. I don't
feel great on medications sometimes, butthere are so many options available so that
we can get the majority of peopleon the right regimen. Sometimes it's hard
to follow up with your doctor,don't have time, So please know we
have telemedicine available and most physicians officesnow have telemedicine available. And of course
(12:56):
there's always that pharmacist at the retailstore to go to. And also cost
cost is an issue, especially whenyou're on a number of different medications.
So there's options there. You know, there's generics, there's combination drugs to
medications in one pill, there's homedelivery, and then we also have a
(13:16):
discount card available on our website.We can talk about later. So those
are the most common, you know, five or six reasons I hear of
why you know medication non adherents occurs. And I want to talk just a
little bit about that relationship with thepharmacist as well, because for some people
that can be a more immediate pointof contact. And you've spent a fair
(13:39):
amount of time working with as chiefpharmacy officer, working in that capacity and
working with those professionals, sometimes youmight have a better relationship with that pharmacist
and might feel a bit more comfortableasking an initial question there and then take
it to your physician and have amore detailed conversation. I think that's a
(14:00):
great piece of advice that you giveto use the resources that are available sometimes
for people as soon as they walkinto the grocery store, absolutely and they're
they're available, they're accessible and happyto answer those drug related questions. They
want to provide this service to you. They want to make sure that you're
doing the best that you can tohave the best quality of life that you
(14:24):
can. And you know, sometimesif people feel like they're having those prescription
issues, I have a side effect. I wasn't expecting I don't like the
way I feel. I feel fine. Let's talk about some best practices that
we in the community can can startto just think about and remember, sort
of like next steps. It's like, okay, you do get that side
effect, Well what do you dofirst? What's the what's a step that
(14:46):
you're going to take instead of justsaying, well, I'm just not going
to take this anymore. Yeah,the first thing I would do is call
your physician or pharmacist and explain whatare you feeling and talk through could it
be a temper effect, side effect? Can it be solved by changing the
time of day, taking with food, etc. Etc. So that conversation,
(15:07):
that first conversation is so critical.Don't let it linger. Don't let
it become so burdensome you can't eventhink about taking that pill again. Have
the conversation. I think that isone of the most important things, is
being just open and honest of theimpact of this medication on your health,
because it was prescribed to make youfeel better, to improve your quality of
(15:31):
life over the long term. Soany any questions you have or side effects
you may be going through, makethat phone call. Do you think that
some people avoid asking the questions justout of playing fear. I think it's
could be fear. It could beI don't want to be a bother.
It could be I don't want tobe an outlier. So yeah, fear
(15:54):
is probably something you know, notknowing there's seven different options that could be
taken, and this one, youknow, if it doesn't work for me,
oh my gosh, there's no otheroptions. So yeah, I think
there's all of all of that anxiety, fear, concern when that first medication
might not feel the way it shouldfeel. And you mentioned it before,
(16:15):
and I want to come back toit in a bit more length. As
about cost, prescription medications can oftenbe very expensive, and that can be
something that a community member would lookat and go, I can't. I
know my doctor's telling me that thisis going to be the right thing for
me, but I just I'm goingto have to sacrifice or not do something
(16:37):
else, or not do other thingsthat are important to the quality of my
life in order to take this medication. So I'm just going to say,
no, I can't do that.And there are options, as you mentioned,
there may be plenty of options thatthe community doesn't even know exist.
So yes, absolutely, cost isimportant. We are hearing this every single
day from our friends and family andpeople in our community. So the first
(17:02):
is, if you have health insurance, be sure to understand what's covered in
under your insurance benefit. Often thereare preferred pharmacies. There are benefits of
using home delivery, so call yourcustomer service line if you need more information,
and the one eight hundred number isright on your card, so feel
free to use it and ask anyquestions you may have. In addition,
(17:29):
we do also and many pharmacies offerdiscount cards. So if someone is currently
paying full price for certain prescription medicationsoutside of their pharmacy plan, they may
be able to access savings by usingour discount card which is called inside our
Ex Prescription Discount Card. It's aprescription savings program that offers savings on thousands
(17:53):
of brand name and generic medications andmore than sixty thousand anticipating pharmacies. And
you know you can compare and shoparea pharmacies and download the discount card by
visiting inside rx dot com forward slashex and there's no it's free to use
(18:14):
it, there's no enrollment, freeand you can really decide what's best for
you, right, you can sortof look at the look at your options
there and say do I use it? Do I not use it. It's
really about being as savvy as youcan as a consumer. Absolutely helps provide
additional piece of information and as I'mmaking yeah, and as I'm looking here,
this could be a substantial resource thatthe community can take advantage of.
(18:37):
The inside RX, it's a prescriptionsavings program that can in some cases offer
some substantial savings on both name brandand generic medications. And the participation that's
available within this pharmacy network is quitesubstantial, so it's probably wouldn't be like,
(18:57):
oh, my pharmacy might not participate. There's a pretty good chance that
if you're using a pharmacy in yourcommunity, it's probably a part of this
network. Here, I would sayabsolutely yes, over sixty thousand pharmacies are
participating and it is absolutely something thatcan be considered if cost is a barrier,
(19:22):
but there's a lot of again,call your health insurance company, understand
your copays, understand your benefits,and of course there's this discount card.
Doctor Monachitre is the chief pharmacy officerat Exceli's Blue Cross, Blue Shield we're
talking about something they call medication adherents. We want you to just remember it's
about if you're on a prescription medication, it's about following those instructions and about
(19:47):
taking it as directed, as prescribed. So what we're going to do in
our last few minutes is really we'regoing to go through some best steps for
you, and we're going to talkreally some specifics about how to help you
will take their medications properly. Let'sstart off with something simple. I arrange
my pills in one of those littleboxes that says that has a letter for
(20:08):
every day of the week, andthat for me is helpful enough. It
just makes sure that I can lookat that box and say did I take
them? Did I not take them? And if I didn't, I do
so. For some people, arrangementis something that could be the first step
they can take instead of having pillbottleseverywhere absolutely and even before that, Joe
(20:30):
is perhaps home delivery and automatic refallreminders, someone reminding you to pick up
your medication or being delivered straight toyour home and then you put it right
in that pillbox so you remember everyday. I love the auto refills,
I love the text messages that Iget that remind me, hey, it's
time to do it again, becauseyou know you'll do you lose track of
(20:51):
time sometime. And auto refills mailorders. All these types of things are
just resources that are available, reallydoctor to make things simple or the consumer
at the end of the day,that's really what it is. If you're
the patient, if you're taking it, you have to have things kind of
made a little easy, and theresources are there. Absolutely, that's that's
(21:11):
the goal. Keep it as simpleas possible. Recognizing you know, healthcare
is complex, so how do weensure our goal? Our collective goal is
to you know, get you totake your medication as prescribed so you have
the best quality of life and outcomethat you can exactly take them. Use
(21:33):
a calendar if you're if you're linkedto your phone, put an alarm on
your phone and label it so thatyou tells you what it is. Make
it part of your routine, Makeit part of your I take these with
breakfast, I take these with thedinner. These are the last thing I
take before I go to bed atnight, so that it's right there on
the bedside table. There are verysimple things, and I think sometimes maybe
(21:56):
we think doctor, that medications areare just not something that we're going to
integrate into our lives. They're alwayssort of standing separate. But maybe if
we shift the perspective on it alittle bit and make them just another part
of the every day when we dohave to take them, if there for
our benefit that just doing those simplethings can make adherence to taking your medication
(22:21):
a far simpler thing to achieve,Great, Joe, integrated part of your
life. And let's just talk aboutin our last two minutes here about the
resources that are available through excelis BlueCross, Blue Shield for members and non
members. It's a great resource thatyou can just go online and find some
of this stuff if you didn't happento take notes, or maybe you want
(22:42):
to hear something or see something again. The website does provide some incredible resources.
Yes, absolutely tips on how totake your medications, how to stay
adherent, some of the tips,Joe that you have already mentioned, and
of course that discount card is availableto every member in our community at no
(23:04):
charge inside RX dot com Forward SlashCapital exc and our goal is to make
this simpler and easier, all right, it's our final sixty seconds doctor,
So I'm going to give you theplatform to make your pitch to everyone out
in the audience there today about theimportance of if you are if you are
(23:29):
given a prescription medication, the importanceof following those directions and having open conversation
with your doctor to make sure thatyou have a great understanding of why you're
taking these drugs and really what todo if they don't seem to be doing
anything for you. Yeah, youknow, at the end of the day,
(23:49):
medications can't work if you don't takethem, and we know they work.
They've been studied and approved because theyshow benefit. So if you are
hesitant, if you can't remember,or if you have a side effect,
have a conversation. You have resourcesright here in the community, your provider,
(24:12):
your doctor, your telemedicine pharmacists,as well as the plan and we
can help collectively improve the outcomes forour community and ensure everyone is healthy and
safe. Doctor Monachitre, who's theChief Pharmacy Officer and President of Pharmacy Solutions
at Excelis Blue Cross Blue Shield,thanks for being a part of the check
(24:33):
in this week. Thanks for joiningus on community check in. A presentation
of excellis Blue Cross, Blue Shieldat iHeartRadio. Podcasts of community check in
are available on the iHeartRadio app orwherever you find your favorite audio content.
For more ways to stay safe,healthy, and educated, visit excelis bcbs
(24:55):
dot com and follow on Instagram andFacebook
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