JAPhA Releases Study Assessing Impact of Appointment-Based Medication Synchronization Program



December 2, 2013 (WASHINGTON, DC) — The Journal of the American Pharmacists Association (JAPhA®) today announced the publication of a study to assess the impact of an appointment-based medication synchronization (ABMS) program on medication adherence and persistence with chronic medications. The article appears in JAPhA’s Nov/Dec issue.

The reasons why patients do not take their medications are complex and varied. Because of the multifactorial nature of medication nonadherence, the most effective interventions typically are individualized to the unique needs of patients. Successful interventions combine diverse strategies that enhance patient access and convenience to medications, offer education and reminders, provide self-monitoring and feedback, engage in mutual problem solving, and offer a range of other approaches. Community pharmacists have been offering variations of these approaches to their patients for many years.

The complexity of a patient's therapy influences medication adherence and it has been suggested that standardizing medication schedules can improve medication adherence and health outcomes. Consequently, several programs that simplify patient medication regimens currently are being offered in community pharmacies. Known by various names, the programs involve pharmacists working with patients to synchronize their chronic refill medications to come due on a single day of the month. By streamlining the refill process and by working together to resolve medication-related issues, it is hypothesized that patients will have better adherence with their prescribed medications.

"This research shows appointment-based medication synchronization to be one of the most effective interventions available to help patients take their medications," said lead study author David A. Holdford, BSPharm, MS, PhD, FAPhA, Professor and Vice-Chair of Graduate Education at the Virginia Commonwealth University School of Pharmacy in Richmond. "Widespread implementation in pharmacies across the U.S. can have a major impact on patient health."

An introduction to the research study appears below. The full-text article is available for a limited time free of charge on the Journal’s website at http://japha.org/article.aspx?articleID=1765641. In addition, a copy can be requested by email from mspinnler@aphanet.org.

Adherence and persistence associated with an appointment-based medication synchronization program

David A. Holdford; Timothy J. Inocencio

Synopsis: This study described how patient adherence and persistence with chronic medications can be improved by allowing patients to meet with a pharmacist to solve medication-related problems and synchronize prescriptions to be dispensed on a single day of the month. Compared with control patients, those in the appointment-based medication synchronization (ABMS) group had 3.4 to 6.1 times greater odds of adherence compared with control patients. Control patients were 52% to 73% more likely to stop taking their chronic medications over 1 year.

Analysis: Although medication synchronization can help remind patients, provide updates on their progress, simplify the process, and make refilling a prescription more convenient, the monthly appointment allows pharmacists to educate, engage, and solve problems. In contrast to the typical prescription-filling process, during which pharmacists react to patients’ needs, the ABMS program allows pharmacists to proactively manage patients’ medication-related needs. The appointment provides an opportunity for pharmacists and patients to engage in mutual problem solving about issues such as physical impairments, lack of affordability, low literacy, and lack of social support. In addition, synchronization can free pharmacists to provide medication therapy management and additional clinical services

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