Philadelphia—Refill synchronization programs not only improve convenience for customers and pharmacists but also can substantially improve medication adherence, according to a new study.
Research published in Health Affairs found that allowing patients to receive all refills at the same time increased medication adherence by more than 10% in some patient subgroups.
The study led by University of Pennsylvania and Humana Inc. researchers notes that although medication synchronization programs have been widely adopted and are currently available at nearly two dozen pharmacy chains and more than 2,000 independent pharmacies in the United States, few trials have measured the effectiveness of the programs.
“The logistical challenges involved with keeping track of remaining pills and obtaining timely refills and renewals are magnified for patients who need to take multiple medications, and often create an obstacle to medication adherence,” explained lead author Jalpa A. Doshi, PhD, an associate professor of Medicine at the Perelman School of Medicine at the University of Pennsylvania, and director of Value-Based Insurance Design Initiatives in Penn’s Center for Health Incentives and Behavioral Economics. “Based on the results of our study, synchronized prescription programs that adjust medication refill dates so that all prescriptions are 'due' for a refill at the same time may be an effective strategy to reducing these obstacles.”
For the study, researchers enrolled 691 Medicare patients receiving two to six oral medications for high blood pressure, high cholesterol, or diabetes via a mail-order pharmacy in a synchronized refill program. Medication adherence was tracked for a year before and after enrollment into the synchronized refill program and compared to a control group of 695 Medicare patients who received “usual care” from their mail-order pharmacy, which included automated reminders about refills but did not synchronize prescription schedules.
Results indicate that patients enrolled in the synchronized refill program increased medication adherence an average of 3% to 4% over the control group; that adherence rate increase is comparable to other widely adopted improvement approaches such as value-based insurance designs.
Interestingly, according to the study authors, patients least likely to follow drug regimens in the past showed the greatest effect from refill synchronization, improving adherence by 9% to 13% over the control group.
“Previous research has shown a direct correlation between medication adherence and improved health outcomes, but future studies are needed to examine whether synchronized refill programs are associated with changes in health outcomes, as well as the economic impact of such programs,” said senior author Kevin Volpp, MD, PhD, a professor at Penn’s Perelman School of Medicine and director of its Center for Health Incentives and Behavioral Economics.
Picking up a regular medication supply is just one component of adherence, the researchers caution, and prescription refill synchronization does not address other common causes of nonadherence, such as forgetting doses or ambivalence to taking medications.
“Nevertheless,” Doshi pointed out, “prescription synchronization can be combined with other types of interventions, based on a patient's specific adherence challenges to further enhance medication adherence.”
“Synchronizing refills might be a promising intervention to improve adherence to maintenance medications, especially among Medicare patients with low baseline adherence,” study authors conclude.
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