Convenience improves adherence

This is one of the goals of Appointment-based medication synchronization (ABMS).  These systems vary in their implementation but they have three common features:

  • All medications refills come due on the same day of the month.
  • Pharmacies place regular call to remind the patient to fill their prescription, typically 5 to 7 days before the scheduled pharmacy visit
  • Patients schedule appointments to pick up medications (or have them delivered). Medication therapy managment and/or disease management programs can be integrated into this appointment.

The question is, does it work?  Using retrospective data from Ohio-based drugs stores, a study by Holdford and Saxena found striking results:

Mean PDC scores ranged from 0.73 to 0.91 for ABMS patients (n=205 to 716) and from 0.57 to 0.71 for usual care depending on the medication class. The percentage of adherent individuals (i.e., PDC≥0.80) was 55% to 84% for ABMS participants and 37% to 62% for usual care. Odds of adherence was 2.3 to 3.6 times greater with ABMS. Usual care patients became nonpersistent (61% to 74%) more often than ABMS patients (33% to 44%) with hazard ratios of nonpersistence being 0.39 to 0.67 for individuals in the program.

For patients with multiple chronic conditions, simplifying their medication regimens is a laudable goal.  Future research should examine whether these improvements in adherence are also correlated with improved health outcomes and lower costs of medical care.



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