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Scheffe Prescription Shop's Medication Synchronization Program

Summary 
  • Need: For adults with chronic conditions, skipping a dose or two is common, but can also be risky. Frequent medication in-adherence has accounted for emergency department visits, hospitalizations, and even death.
  • Intervention: The Scheffe Prescription Shop in Enid, Oklahoma started a medication synchronization program. Pharmacists serve as care coordinators for patients by prepackaging pills, scheduling recheck appointments, and providing pickup reminders and medication education over the phone.
  • Results: The program has reduced the number of trips patients have to take to the pharmacy to pick up their pills and has increased medication adherence rates over 4 years.

Description

For adults with chronic conditions on multiple medications, skipping a dose or two is a common problem. But non-adherence is risky and has accounted for emergency department visits, hospitalizations, and even death.

According to the American Pharmacists Association Foundation, patients who participate in medication synchronization programs are 3 to 6 times more likely to stick with their medication regimen. In the past, penalties were given to pharmacies who tried to sync patients' medications, but in 2014, medication synchronization (med sync) was first legalized. It has since been passed into law for nearly half of the states.

Med sync programs allow pharmacies to help ease the financial and logistical burdens for patients and increase medication adherence rates. Med sync allows a patient to pick up all of their prescriptions on the same day every month, reducing trips to the pharmacy, hospitalizations, emergency department admissions, and outpatient visits.

In 2015, Oklahoma passed a law that allowed pharmacies to conduct med sync programs. That year, the Scheffe Prescription Shop in the town of Enid, Oklahoma started a med sync program. With support from the National Community Pharmacists Association, the privately owned pharmacy invited patients with chronic conditions taking multiple medications to enroll.

Scheffe Logo - Medication Synchronization Program

Three Scheffe pharmacists manage the service, taking on the role of pharmacy care coordinators, getting authorization from providers and reminding patients about checkup appointments when needed. Over the phone, the pharmacists review patients' medication instructions, educate patients on medication adherence, and answer questions.

This program has been fully integrated into Scheffe's services and is financially supported by the pharmacy.

Services offered

The following steps are included with Scheffe's med sync program:

  • A computer system notifies the pharmacy 5-7 days before the patient's medication is due to be filled.
  • The pharmacist reviews the patient's entire medication list to see if adjustments are necessary.
    • Within the first few months of a patient being on the program, the pharmacy may have to do a small medication refill (such as 3, 5, 10 days) to get all of the patient's medication on the same refill schedule.
  • Once their medications are synchronized, the pharmacy notifies the patient, answers their questions, and reviews medication instructions. This usually happens once a month over the phone, but patients can also opt in to receive text message reminders.
    • The pharmacy requests insurance carriers to prorate the patient's copay ahead of time to relay the cost to the patient at the time of their phone call reminder.
  • Patients can either pick up their medication from the pharmacy or request a delivery.

Pack My Meds is an additional program offered to those enrolled in Scheffe's med sync program. Each dose is packaged with other pills that are to be taken at the same time of day. This can relieve a burden from the patient or caretakers who normally fill pillboxes every week. It can also help prevent pills from getting mixed up or lost if a pill box spills. This video has more information:

Results

Scheffe's Prescription Shop's goal is to get to 350 patients signed up for their med sync program. Currently, there are 295 patients enrolled. Their initial goal was to reach 85-90% compliance rate for those enrolled in the program, which they did. Medication adherence rates of patients enrolled were greater than the rates of patients not enrolled in the med sync program. Below is a comparison between the two groups:

Patient Adherence Rates
Month/Year % Adherence, Not Enrolled % Adherence, Enrolled
August 2015 76.5 88.4
August 2016 84.0 88.4
August 2017 84.5 90.8
August 2018 92.0 94.3

The pharmacy has experienced an increased in the number of questions posed by patients during their phone call with the pharmacist. This program has also been helpful in securing a checkup for patients with their providers before their medication runs out, keeping them consistent with their medication regimen.

Since help with medication management is one reason why older adults enter into long-term or assisted living care, this program has also played a key part in allowing people to stay home for longer periods of time.

Barriers

Challenges the Scheffe Prescription Shop encountered throughout the process:

  • One common reason some medications are not picked up from pharmacies is because of their high cost. When this is the case, Scheffe pharmacists contact the provider to see if a less expensive alternative medication can be prescribed instead.
  • As with any program, there was a trial period to work out the glitches of the program. When launching the program, it was difficult to get patients to participate. Once they did, the challenge became retaining those patients in the program. Since the start of the program, the program's coordination and communication has improved.
  • Not all insurance companies cover partial refills for medications (often needed when starting a patient on the program). In 2017, a bill was signed into law that allowed for this service once a year for every patient.

Replication

Scheffe Prescription Shop recommends a focused effort and involving pharmacy staff in enrolling as many patients as possible when starting a med sync program. The improvement in workflow will begin to show when about 50 patients are enrolled and will become even more noticeable after about 100 patients join the program.

Contact Information

Steven Pryor, Pharm.D., Managing Partner
Scheffe Prescription Shop
580.233.2152
steve.p@prorx.net

Topics
Care coordination
Chronic disease management
Pharmacy and prescription drugs

States served
Oklahoma

Date added
November 9, 2018


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