Utilizing a Pharmacist-Community Health Worker Collaboration to Address Medication Adherence Barriers

Abstract Background Medication nonadherence impacts health care costs and leads to poor clinical outcomes. Pharmacists are positioned to evaluate and educate patients regarding medication adherence; however, opportunity exists to leverage a collaboration to elicit barriers that patients may encounter, especially in minority groups. Community Health Workers (CHWs) are individuals from the communities who form relationships with patients to help increase access to healthcare resources. Combining the strengths of a pharmacist with a CHW can potentially improve medication use and outcomes in high risk populations. Objective Evaluate the effectiveness of a collaboration between CHWs and pharmacists in identifying and addressing medication adherence barriers faced by hypertensive patients. Methods After receiving training in medication therapy management support, CHWs from the South East American Indian Council collaborated with students and pharmacists from the Center for Quality Medication Management at the University of Florida to identify and address medication adherence barriers encountered by hypertensive patients who were mainly Native American or Black. The CHWs documented information from the patient interviews during initial and follow-up visits. The team collaborated to identify intervention opportunities based on the adherence barriers identified. Follow-up visits were conducted to measure progress. Results Thirty-three hypertensive patients with or without diabetes were included in the study. Pharmacists, in partnership with CHWs, offered 149 interventions related to medication adherence barriers. The most commonly identified barriers included forgetfulness, side effects, and knowledge concerns. By the final visits, 75.6% of the barriers related to antihypertensive medications and 63.9% of the barriers related to antidiabetic medications were resolved. In addition, a paired t-test indicated a significant difference in the mean blood pressure value recorded at the initial (M=136/85.7 mmHg) and final (M=130.1/81.2 mmHg) visits. Conclusions The findings of this pilot project support the collaboration between pharmacists and CHWs to help improve medication adherence and patient outcomes. Additional research is recommended to validate these study findings.