Addressing noncompliance and side effects

A 67-year-old female was referred to Mosaic Pharmacy Service for medication management. The member has a past medical history of high blood pressure, diabetes, insomnia, and depression. She was not compliant to her new diabetes medication due to unwanted side-effects and was only taking it as needed. Following a home visit and clinical review, the following drug therapy problems were identified:

• The prescribed sleep aid was not recommended for geriatric patients
• Patient’s blood sugar was too high due to medication non-adherence

Given the above drug therapy problems, the clinical pharmacist aimed to achieve the following goals:

• Check blood sugar twice a day and record the value
• Begin adhering to her blood sugar medication every day
• Sleep through the night

To achieve these goals, the following interventions were made to optimize the medication regimen and care management:

• The patient was counseled on a diabetic diet and methods to stay adherent to her medication regimen
• A recommendation was made to the patient’s doctor to switch to a combination pill to increase adherence and decrease cost
• Another recommendation made was to the patient’s doctor to switch the sleep aid to a safer one for her age
• Start patient on Mosaic medication synchronization program

As a result of Mosaic intervention, the member is now compliant with her medication regimen; switching the member to a combination diabetic medication also resulted in $120/year savings to the member and $7,500/year in savings to the member’s health plan.