Access to Care: Development of a Medication Access Framework for Quality Measurement

Access to Care: Development of a Medication Access Framework for Quality Measurement

Patients face barriers almost every step of the way in their efforts to gain access to the treatment or care that they need. A new framework, developed by the Pharmacy Quality Alliance (PQA) and supported by the National Pharmaceutical Council (NPC), identified seven main areas patients encounter while seeking access to medications and the structural, financial and personal barriers patients face within each.

“Barriers to medication access and compliance have long been acknowledged as a serious problem for the U.S. health care system, costing billions of dollars in lost productivity, additional doctor visits, preventable hospitalizations and nursing home admissions, and even premature death. This framework provides us with actionable steps to break down those barriers to patient care,” said Kimberly Westrich, MA, NPC Vice President of Health Services Research.

The framework describes the cyclical nature of medication access. It begins with a patient’s awareness of an illness or condition that induces a need to seek treatment and ending with medication adherence. Common barriers patients encounter are noted within each point in the process of accessing medications. Patient health literacy was the most common barrier identified. Other barriers include medication-related costs and insurance.

The framework is the centerpiece of a PQA report, Access to Care: Development of a Medication Access Framework for Quality Measurement, released today. The report is the product of PQA’s Access to Care Roundtable, a multi-stakeholder panel of experts in social determinants of health, health care quality improvement and quality performance measurement. The intent of the framework is to inform high priority medication access areas that could be targeted for potential quality measure development.

“Access to medications is an important part of high-quality, value-based health care,” said Matthew Pickering, PharmD, PQA’s Senior Director of Research and Quality Strategies. “Improving access, which affects adherence and patient outcomes, requires a focus on the social determinants of health. The framework we have developed holistically defines medication access and identifies gaps in quality measurement that could address the financial and non-financial factors that stand between patients and the medications they need.”

The full report, Medication Access Framework for Quality Measurement, is available on the PQA website.