Training may help patients challenged by high drug costs

Do you think your doctor knows—or cares—what it cost you to get a prescription filled? Even though out-of-pocket costs for medications can be a significant burden, asking patients if they're concerned about it isn't typically part of most office visits.

University of Rochester Medical Center research suggests that a modest training session for doctors and their office staffs might encourage this interaction, potentially making it a routine and effective way to help assure patients are getting and taking their medications appropriately.

The study, "Addressing Medication Costs During Primary Care Visits: A Before–After Study of Team-Based Training," published this month in the Annals of Internal Medicine, involved clinicians and staff at seven primary care practices in three states. Teams at each practice participated in one-hour training sessions to guide them in understanding how important the issue is to patients, screening for patients who may need help, and learning some cost-saving strategies for their patients. To determine the training's impact, 700 adult patients taking at least one long-term medication were surveyed—half before the training and half for three months after the training intervention, and 45 staff members were interviewed.

Training improved the rate of cost-of-medication conversations in six of the seven practices involved, increasing the frequency of these conversations from 17 percent to 32 percent. Staff interviews identified variations in how each practice approached the patient screening, workflow, and strategies for addressing medication costs with patients.

"We are encouraged that the training intervention doubled the rate of these cost-of-medication conversations," said researcher Kevin Fiscella, MD, MPH, professor in URMC's Department of Family Medicine. "It's important for patients to understand they have options and that their doctor doesn't want the cost of medications to be a burden that prevents them from taking them. This training is a way to provide physicians and practice staff with tools for broaching the topic with patients."

Strategies to help defray costs can range from identifying equally effective alternatives to more costly medications to guiding patients to resources that may help defray costs.

"This study provides evidence that a single team training to screen and address patients' medication cost concerns can make a difference. And it sets the stage for further research to assess how an intervention such as this might benefit patients in the long term, and whether additional interventions might help," Fiscella added.