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C h a i n D r u g s t o r e D a i l y 1 9 M o n d a y, A p r i l 2 7 , 2 0 1 5 THE MEDICATION "HABIT LOOP" By Dave Dwyer, Vice President of Marketing for MWV Healthcare, Adheris Patient medication non-adherence is pri- marily driven by behavioral reasons, such as simple procrastination or forget- fulness (69 percent), an Express Scripts study uncovered. In order to improve adherence, we must find solutions that change behavior. Habits are an important aspect of human behavior, writes Charles Duhigg in a recent bestselling book called the "The Power of Habit." Duhigg points out that habits make up 40 percent of our daily routine, and they all start with a psychological pattern called a "habit loop," which is a three-part process. First, there's a cue, or trigger (loca- tion, time of day, other people, pattern, etc.) that tells your brain to go into auto- matic mode and let a behavior unfold. Then there's the routine, which is the behavior itself. That's what we think about when we think about habits. The third step is the reward: something that your brain likes that helps it remember the "habit loop" in the future. So how do we help patients develop an adherence habit? Duhigg writes that to understand a habit, you have to start by identifying and understanding the rou- tine's trigger and reward. The cues for medication are the same as any other behavior (location, time of day, other people, pattern, etc. ). In the United States, today the patient's behav- ior is typically taking medication from an amber vial. The immediate reward for taking medica- tion is usually an emotion- al benefit, as health improvement is not seen straightway with most medications. And frequently, taking medication causes mixed emotions, as it can remind patients that they are "sick." With the onus on variable human behavior, and a weak cue and reward, it can be difficult for people to develop a positive habit loop. The opportunity for pharmaceutical manufacturers is to implement an inte- grated and layered adherence strategy that drives and reinforces the patients' journey to positive medication behavior and a strong "habit loop." This is done by enhancing the trig- ger or cue, such as text messages or visu- al reminders such as calendars on blister medication packaging. Make sure to use tools that help rein- force important med- ication information, support patients, and simplify the patients' regimen for daily medication execution. Provide patients with a "sum of behav- ioral feedback" of their own medication taking, which can lead to the reward of self-efficacy, strengthening the patients' accountability to improve their own health. This can elevate the importance of the entire loop to the patient. Allowing a patient to track and see their own medication-taking behavior is the most impactful intervention to enhance adherence. For further information, visit MWV at www.mwv.com or email healthcare @mwv.com. During the NACDS Annual Meeting visit at Table #432. PHARMACY ADVOCATES MEET WITH CONGRESSIONAL REPRESENTATIVES More than 350 pharmacy advocates from 44 states met with members of Congress during the seventh annual NACDS RxIMPACT Day on Capitol Hill. Pharmacy advocates conducted more than 450 meetings with members of Congress, including 95 percent of the members of Congress who serve on Congressional committees with jurisdic- tion on healthcare issues. NACDS presented its Congressional Leadership Award to House Energy and Commerce Health Subcommittee Vice Chairman Brett Guthrie (R-KY). NACDS recognized Guthrie for his spon- sorship of legislation – both in this Congress (H.R. 592) and the last Congress (H.R. 4190) – that enables Medicare beneficiaries to access pharma- cist-provided patient care services. "Living up to its name, NACDS RxIMPACT Day on Capitol Hill is highly impactful," said NACDS President and CEO Steven C. Anderson, IOM, CAE. "Decisions on policies made in Washington influence patient care in phar- macies everyday across the nation. This annual event is an important opportunity for pharmacy advocates to engage directly with lawmakers on pro-patient, pro-phar- macy policies, and to further reinforce the recognition by lawmakers of the evolving role of pharmacy in patient care." This year's NACDS RxIMPACT Day on Capitol Hill program included promi- nent speakers. Amy Walter, National Editor of The Cook Political Report, delivered the keynote address, providing timely insights on the current political landscape and predictions leading up to the presidential election in 2016. "Pharmacists are uniquely posi- tioned in their expanded roles in the healthcare delivery system to help meet the healthcare needs of all Americans," said Anderson. "Pharmacy has an impor- tant part to play – working collaborative- ly with other healthcare professionals and providers - in providing patient care for those in need."