The World Health Organization (WHO) has found that 50% of patients, on average, in developed countries with chronic diseases are adherent to medication. Medication synchronization, a program in which a patient’s medications are filled all on the same day, has been shown to improve adherence.

Medication synchronization reduces emergency visits and hospitalizations.

The Appointment Based Model (ABM) is a type of medication synchronization where patients have 1 or 2 appointed days a month to pick up their medications. On these visits, pharmacists perform services such as a comprehensive medication review.

These programs help patients stick to their medication regimens and also help keep workflow predictable at pharmacies. Demands on pharmacist time and adapting to a new process can prevent implementation, however.

A study in the Pharmacy Journal looked at the pharmacy technician’s role in the ABM process. The researchers interviewed pharmacy technicians to find what they thought about the program and its implementation.

One hurdle identified was that technicians felt that the training was poor because while it did explain the program’s goals, it did not explain how to use the associated software. The technicians preferred more hands-on instruction to learn how to use the software.

Technicians also reported the ABM process to be lower than their normal required tasks in terms of priority limiting the time they could devote to it. Technicians believed that the program had value in simplifying patient’s medication regimens.

Technicians also reported that lack of integration between the ABM platform with the dispensing software system. This led to issues like prescriptions “falling off” or old prescriptions to be filled in error. These errors disrupted workflow as it was time consuming to manually enter all of a patient’s medications and calculate current number of dosage units to fill based on the number the patient should currently have on hand.

Barriers to the ABM model also came from patients.

Pharmacy technicians reported that older patients liked their regular visits to the pharmacy and were resistant to change. Other patients were hesitant because of the consolidation of cost of medications on a single day of the month, rather than being able to spread out their medication costs.

Successful ABM implementation and pharmacy staff buy-in was best achieved when a pharmacy technician acted as a champion for the program. These champions trained other pharmacy staff on the program’s use and identified patients who could benefit from the service.

Overall pharmacy technicians reported pharmacy staff and patients appreciated their effort.

Although there is still much optimization to be done in implementation, lessons learned from this study can help other pharmacies implement ABM programs. Integrating software, allotting time for ABM tasks, and promoting champions of these programs are all takeaways to smooth implementation at other sites.
 
Ivan Navarro, 2020 PharmD Candidate at the University of Connecticut in Storrs.

REFERENCE

Renfro C, Coulter D, Ly L, et al. Exploring Pharmacy Technician Roles in the Implementation of an Appointment-Based Medication Synchronization Program. Pharmacy 2020, 8, 28.