Determine causes and scope of abandoned prescriptions -- Researchers know little about how often and why prescriptions are filled but not picked up at the pharmacy. A better understanding of the types of essential medication abandoned and the predictors of abandonment can be used to create better approaches to medication delivery. Specifically, the team will study the effect of different insurance structures to help design plans to support medication adherence. The study also seeks to determine the impact of the current economic downturn on insurance coverage and prescription abandonment to provide guidance on how best to support patient health in such economic conditions. Drive adherence through simplification and consolidation -- In a fragmented health care system, there are numerous sources of complexity that may interfere with medication adherence. Patients see multiple physicians, are charged multiple copayments for different medications, may use multiple pharmacies and may have to make many trips to the pharmacy to manage their medications. The research team will seek to assess how actions such as simplifying drug regimens and consolidating pharmacy management services within a "pharmacy home" can improve adherence. This research will provide the basic knowledge needed to help pharmacies, insurers and doctors simplify medication use and encourage adherence. Evaluate the clinical and financial value of adherence incentives -- Scientific literature has discussed the notion that rewarding desired behavior is a powerful tool to stimulate that behavior. The team is developing a randomized controlled trial of the effects of providing rewards for optimal medication adherence with the goal of better engaging patients in their medical care in order to improve their health. The results can provide a rigorous evaluation of the clinical and financial value of implementing novel insurance designs on patient behavior. Determine how electronic prescribing impacts costs, compliance and safety -- Many health care experts are looking to improved health information technology to reduce health care costs and improve safety. The researchers will examine the role that ePrescribing can play in adherence in helping companies better understand and evaluate how electronic prescriptions and processing impact medication costs, adherence and safety. This is especially important as Medicare has launched an initiative to drive electronic prescriptions.

"This research will help us understand the reasons why patients do not take their medications as prescribed. We will use this information to develop effective, evidence-based approaches to improve prescription adherence," said William Shrank, M.D., MSHS of Brigham and Women's Hospital and Assistant Professor of Medicine at Harvard Medical School, and principal investigator of the program. "We'll strive to better understand barriers to adherence that range from patient characteristics (e.g. income or marital status); patients' attitudes about their condition and the importance of medicine; understanding how to take medications appropriately; the impact of complex therapy; and, the trust and communication between the patient, the physician and the pharmacist. We hope this research will help us create strategies to promote wellness in our patients. "

SOURCE CVS Caremark