Lead author Alexis A. Krumme, a research scientist in the Division of Pharmacoepidemiology and Pharmacoeconomics, Brigham and Women’s Hospital, in Boston, Massachusetts, and her team evaluated the impact of medication synchronization on changes in adherence, cardiovascular events, and resource use among Medicare beneficiaries treated between 2011 and 2014 for two or more chronic conditions. Medication synchronization is a system that coordinates an alignment in prescription fill dates for all of an individual patient’s medications.
The chronic conditions included at least one of the following: hypertension, hyperlipidemia, or diabetes, and the analysis included two different synchronization programs. For the nearly 23,000 patients matched by propensity score, the mean number of days of measured medication adherence for the synchronized group compared with the control group of patients without a synchronization program was 3% higher (0.87 vs. 0.84). The improvement in overall adherence in synchronized patients was three times greater in patients with low baseline adherence, compared with those with higher baseline adherence. These percentages, although seemingly low, represented a large impact given that health experts anticipate chronic care–management patients to increase to 157 million by 2020.
The authors noted, “Our results are similar to those from an evaluation of a mail-order refill synchronization program conducted in a population of Medicare managed care beneficiaries, which suggests that addressing logistical issues related to medication supply may be the principal mechanism for these programs’ success.” The team also suggested that more research is needed to determine the supplemental impact of the pharmacist involved in the medication-management process. “While we were not able to determine which components of the pharmacy-based synchronization program were most effective, the moderate success of other pharmacist-led interventions to improve adherence may mean that further study of the long-term effects of engaging pharmacists in medication synchronization programs is warranted.”
Many medication-synchronization programs are capable of automating prescription refills and packaging multiple medications in single-administration blister packs that improve patients’ ability to self-organize their personal medication-administration experience.
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