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Pharmacies on the Front Lines: Tackling Patient Noncompliance

  • June 29, 2011
  • RPh on the Go

According to a study published in the New England Journal of Medicine, chronic patient noncompliance – refusal or inability to take prescribed medications – results in nearly $300 billion in avoidable costs to the healthcare system when patients wind up in the hospital. Pharmacies, especially independents that have more time to focus on customer services, are in a unique position to identify issues and facilitate change.

Doctors have no way of knowing whether a patient fills or take his medications as prescribed unless the patient reports honestly at the following visit. Only the pharmacist knows whether medications are refilled on time, and only the pharmacist is in a position to discuss medications in depth with a regular patient. The value of the pharmacist-customer trust relationship is the key here. To truly be part of the medical team and not simply a pill counter, it is your responsibility to open the lines of communication. There are a variety of reasons why patients might refuse to fill their medications.


The escalating cost of medications has left some patients with the choice of medicines or food, or worse, medicines or food for their children. Women, especially, will put their needs last on the list.

Trust Issues

The internet is a wonderful and terrifying thing. Every patient experience, every horror story, and every charlatan trying to make a buck from miracle snake oil can reach and influence patients. Increasingly, before consumers spend money on anything, they search the web for consumer experiences. They are far more likely to find the worst experiences than the best. Calling the doctor to ask questions often results in an impersonal answering system shuffle that ends with leaving a message for a callback that may or may not come the same day, and then more often than not by a nurse or office assistant. Few things can kill trust as well as “Your call is important to us…”


For a patient with a serious chronic illness, fear of side effects can often be more frightening than fear of the disease. When it comes to a silent killer like high cholesterol, high blood pressure, or even in some cases diabetes, taking medication with a long list of side effects may be more intimidating than possibilities of complications.

How you can help

When a patient comes in, ask if the doctor has prescribed anything new. Patients may not mention that they are not planning to fill a prescription, but most people won’t lie when asked a direct question. The simple act of asking may open a dialogue you can answer. You can allay fears of side effects, point out the foibles of unproven OTC remedies, discuss the seriousness of the problem, point them to drug manufacturer sources that offer rebates or discounts, talk about generics, or even suggest that they contact the doctor and discuss the cost and ask about a lower-cost alternative. For insurance companies, patient compliance means lower spending. For pharmacies and drug manufacturers, it means more profit. For doctors, it means accurate information. But most importantly, for patients, it means better care and better health.

Are you comfortable enough with customers to open that dialogue? Is the trust relationship already in place? If you don’t have time speak to every customer personally, is your staff trained to ask leading questions?

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