A sample workflow to address medication nonadherence related to cost

The high cost of prescription drugs keeps many patients from taking the medications they need, but most patients will not mention their cost concerns unless specifically asked.

To quickly screen for and address prescription cost concerns, you and your staff can use the following workflow.

Front-desk receptionist:

• Asks the patient to review the medication list, which involves crossing out inactive medications, writing down new medications, and circling any that are a cost burden.

Rooming nurse:

• Reviews the list with the patient in the exam room and confirms that the circled prescriptions are a cost burden.
• Adds the patient’s concerns about the cost of the circled prescriptions to the chief complaint in the medical record.

Clinician:

• Reviews prescription concerns with the patient to identify causes.
• Considers whether the medication is still necessary and, if not, whether a deprescribing trial is feasible.
• Considers extended prescriptions.
• Considers lower-cost alternatives, discount programs, and cost-saving websites and apps.
• Refers the patient as needed to office staff or community-based organizations to assist with insurance concerns, including eligibility for low-income subsidies.

Read the full FPM article: “A Practical Approach to Reducing Patients' Prescription Costs.”