title: Medication adherence communications in community pharmacies: A naturalistic investigation.
abstract: OBJECTIVE
  To describe the extent of pharmacy detection and monitoring of medication non-adherence, and solutions offered to improve adherence.
  
  
  METHODS
  Participants were 60 residents of the Boston area who had a generic chronic medication with 30 day supplies from their usual pharmacy. Participants received a duplicate prescription which they filled at a different pharmacy. For 5 months, participants alternated between the two pharmacies, creating gaps in their refill records at both pharmacies but no gaps in their medication adherence. Participants followed a scripted protocol and after each pharmacy visit reported their own and the pharmacy staff's behavior.
  
  
  RESULTS
  Across 78 unique community pharmacies and 260 pharmacy visits, pharmacies were inconsistent and inadequate in asking if participants had questions, discussing the importance of adherence, providing adequate consultations with new medication, and detecting and intervening on non-adherence. Insurers rarely contacted the participants about adherence concerns.
  
  
  CONCLUSIONS
  There is a need for more structured intervention systems to ensure pharmacists are consistently and adequately educating patients and detecting/managing potential medication non-adherence.
  
  
  CONCLUSIONS
  The present study calls for more attention to building infrastructure in pharmacy practice that helps pharmacists more consistently identify, monitor, and intervene on medication adherence.
authors.affiliation: Department of Pharmacy and Health Systems Sciences, Northeastern University, Boston, MA, USA. Electronic address: n.rickles@neu.edu.
authors.forename: Nathaniel M
authors.initials: NM
authors.lastname: Rickles
authors.affiliation: Center for Health Policy and Healthcare Research, Northeastern University, Boston, MA, USA.
authors.forename: Gary J
authors.initials: GJ
authors.lastname: Young
authors.affiliation: Department of Psychology, Northeastern University, Boston, MA, USA.
authors.forename: Judith A
authors.initials: JA
authors.lastname: Hall
authors.affiliation: Department of Communication Studies, Northeastern University College of Arts, Media, and Design, Boston, MA, USA.
authors.forename: Carey
authors.initials: C
authors.lastname: Noland
authors.affiliation: Department of Pharmacy and Health Systems Sciences, Northeastern University, Boston, MA, USA.
authors.forename: Ayoung
authors.initials: A
authors.lastname: Kim
authors.affiliation: Department of Pharmacy and Health Systems Sciences, Northeastern University, Boston, MA, USA.
authors.forename: Conner
authors.initials: C
authors.lastname: Peterson
authors.affiliation: Department of Pharmacy and Health Systems Sciences, Northeastern University, Boston, MA, USA.
authors.forename: Mina
authors.initials: M
authors.lastname: Hong
authors.affiliation: Department of Pharmacy and Health Systems Sciences, Northeastern University, Boston, MA, USA.
authors.forename: John
authors.initials: J
authors.lastname: Hale
mesh_terms: D000328:Adult; D001900:Boston; D003142:Communication; D003376:Counseling; D005260:Female; D006306:Health Surveys; D006801:Humans; D008297:Male; D055118:Medication Adherence; D008875:Middle Aged; D010353:Patient Education as Topic; D010594:Pharmacies; D010595:Pharmacists; D024382:Professional Role; D011369:Professional-Patient Relations; D011795:Surveys and Questionnaires
keywords: Medication adherence; Medication education; Naturalistic design; Pharmacies; Pharmacists; Pharmacist–patient communication