Mail-order pharmacy improves stroke survivor adherence

Where possible, executives may want to encourage the use of mail-order pharmacy for patients who have experienced a stroke, a new study suggests.

Research compiled by a Medical University of South Carolina expert shows that using mail-order pharmacies may help stroke patients adhere to their medication regimens.

Bruce Ovbiagele, MD, of the Medical University of South Carolina in Charleston and the International Stroke Conference, analyzed data from Kaiser Permanente. The researchers looked at the prescr

Ovbiageleiption refill records of patients discharged with ischemic stroke and who were prescribed anticoagulant and cholesterol-lowering drugs between 2006 and 2015.

They found that 73.9% of prescriptions for statins and anticoagulants were refilled when patients used mail-order pharmacies compared to 46.5% through local pharmacies.

“[Mail-order pharmacies] seem to be associated with greater long-term medication adherence on the part of patients, and indirectly-although not proven yet-might be associated with better clinical outcomes and lower costs,” says Ovbiagele.

Stroke patients are at high risk for repeat strokes which often cause further disability, longer hospital stays, and higher likelihood of chronic institutionalization, according to Ovbiagele.

“So outcomes after a repeat stroke are often worse than after a first-time stroke, with a correspondingly higher cost of management,” he says. “Enhancing adherence to medications proven to prevent repeat strokes from occurring could avert additional disability or even death in these patients, as well as greatly reduce costs.”

Overall, mail-order pharmacy is a reasonable strategy for many types of patients “given the convenience of having the drug delivered to the home, which just makes it easier to ensure a patient does not forget or have to go out of his/her way to pick up the medication every time they are about to run out,” Ovbiagele says. “However, stroke patients can be especially vulnerable to suboptimal medication adherence with the typical pick from the local pharmacy because many stroke patients have lingering challenges with memory or ambulation such that having to always remember to pick up the medications directly from the pharmacy or relying on others to regularly help pick up the medications can be problematic.”

Apart from the novel anticoagulant medications for preventing strokes due to atrial fibrillation, most of the drugs used for preventing repeat strokes are generic or are not cost-prohibitive, according to Ovbiagele.

“Moreover, the monies spent on stroke patients adhering to any of these medications-including the novel anticoagulants-in a sustained manner should be well worth it, given the tremendous expense associated with the occurrence of repeat strokes,” he says.