With the prevalence of chronic diseases such as diabetes, asthma, and hypertension, there is a desperate need for pharmacists to help patients keep multiple prescriptions organized and remain adherent to medications. Some pharmacies across the country are pilot testing programs to make it easier for patients to keep up with their prescription refills and stay on track. This promising development is providing new patient engagement opportunties for pharmacists.
Patients who are on complex medicine regimens for multiple chronic conditions often have difficulty juggling their medications. This can lead to missed doses, missed medications, and a decrease in medication adherence. Medication synchronization (med sync), an emerging trend in pharmacy practice, encourages patients to pick up all their recurring monthly prescriptions on the same day, usually once per month.
The concept of med sync is often paired with an emerging model of care called the appointment-based model (ABM), which improves patients’ adherence to medications by designating one day each month to pick up all medications. The ABM and med sync shift the focus from filling patients’ prescriptions on a variable basis to scheduling one single pick-up date for chronic medications.
Using the ABM, pharmacists call each patient before a scheduled appointment to identify any medication changes, confirm that each prescription should be refilled, and verify that the patient is receiving the correct medications.
During the appointment, pharmacists review patients’ current medicine regimen and discuss any medication problems. This interaction improves the pharmacist–patient relationship and provides ongoing opportunities for both the patients and the pharmacist to address adherence improvement.
In addition to promoting medication adherence, the ABM and med sync eliminate the need for patients to remember to call in to renew their prescriptions. Having one appointment per month to refill all prescriptions at once is more convenient and translates to fewer trips to the pharmacy. It also keeps patients from worrying about running out of medications. Patients know ahead of time that their medications are in stock and will be ready for pick-up without any delays. Finally, with the ABM, patients have the opportunity to talk one on one with their pharmacist on a regular basis.
In 2013, the APhA Foundation published a white paper focused on the med sync/ABM program. The white paper described the benefits and implementation requirements of the ABM, summarized the results of several studies, and provided guidance for implementing and marketing a med sync/ABM program.
Thrifty White Pharmacy, an employee-owned pharmacy in the Midwest, applied the ABM model as part of their research protocol along with med sync. A study evaluating the success of Thrifty White’s AMB program was published in the November/December 2013 issue of the Journal of the American Pharmacists Association. Patients were divided into categories based on six types of medications that are commonly refilled (ACE inhibitors/angiotensin receptor blockers, beta blockers, dihydropyridine calcium channel blockers, thiazide diuretics, metformin, and statins).
For patients in all six categories, those who participated in the med sync/ABM program had 3.4 to 6.1 times greater odds of adherence compared with control patients, the study noted. Patients not participating in the program were 52% to 73% more likely to stop taking their medications.
The success of the model supports the white paper’s conclusions that “the ABM… [improves] consumer adherence, persistence, and satisfaction. It also improves efficiency for the consumer and the pharmacy staff, while creating an ongoing conversation with each consumer to help optimize medication use.”