Ask About Adherence: Q&A with Pharmacy Quality Alliance

Ask About Adherence is a blog series featuring Q&A’s with experts in medication adherence. In this post, we speak with Laura Cranston, Pharmacy Quality Alliance (PQA) executive director, on medication synchronization.

Stay tuned for the next Q&A and be sure to share your thoughts in the comments section below. We’d love to hear from you on ways to improve medication adherence!

SAMANTHA DOUGHERTY: What is medication synchronization and what value does it bring to patients

LAURA CRANSTON: Medication synchronization using the appointment-based model (ABM) is an emerging approach to workflow and operations within community pharmacies that involves the establishment of a set date for all of a patient’s medications to be refilled on a monthly basis, and allowing the pharmacist and patient to utilize this consistent date to build on the provision of clinical services and the opportunity for enhanced medication management services.

Through simple adjustments to how pharmacists engage with their patients, we are seeing marked improvements in how patients and pharmacists can work together to manage patients’ medication therapy.  This leads to stronger medication adherence and better patient medical outcomes.

There are three core features to ABM.  First is the alignment of patients’ chronic medications such that they all come due for refills on the same day.  Next, rather than the patient calling in to refill medications, the pharmacy reaches out to the patient several days in advance of the medication coming due. This call is to review the medications to be filled, and to identify any additional medications that the patient may have received from other providers.  Lastly, is the appointment day itself.  During this time pharmacists provide patients their medication and related pharmacist services.

DOUGHERTY: What additional benefits does the appointment-based model offer? 

CRANSTON: In 1992, the American Association of Colleges of Pharmacy voted to move all schools of pharmacy to the Doctor of Pharmacy degree.  Since that time, pharmacists have used their expanded graduate-level training to offer an array of services to patients, from immunizations to chronic disease management.  ABM has a dramatic effect in facilitating the delivery of these ancillary pharmacist services beyond medication dispensing.  Besides improvements in patient care, ABM also increases safety and efficiency for the pharmacy.  Medical practices are directly impacted as well with alignments of refill requests for all the patient’s chronic meds leading to more efficient patient reviews for the prescriber.

DOUGHERTY: How many patients and pharmacy chains are currently participating and what factors do you think affect broad adoption of medication synchronization?

CRANSTON: Today nearly 10,000 pharmacies are participating in this model nationwide, including both chains and independents.  That’s about a sixth of community pharmacies, but with many large and midsize chains currently piloting ABM services, there is tremendous room for growth.  Our estimates place about 750,000 patients currently benefiting from ABM services.  For ABM to keep growing, we need three key things: patients to request the service, pharmacies to offer the service, and payors to support the service.  Further research into ABMs impact in patient health could lead to policies that both increase awareness and demand for the model, pharmacy’s interest in adopting it, and payors willingness to incentivize this model.

For more information on PQA, please visit www.pqaalliance.org.

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