Adherence and persistence associated with an appointment-based medication synchronization program
David A. Holdford; Timothy J. Inocencio
J Am Pharm Assoc (2003) 2013;53:576-583. doi:10.1331/JAPhA.2013.13082
View Author Identification Section
David A. Holdford: David A. Holdford, BSPharm, MS, PhD, FAPhA, Professor and Vice-Chair of Graduate Education, School of Pharmacy, Virginia Commonwealth University, Richmond
Timothy J. Inocencio: Timothy J. Inocencio, PharmD, PhD, PhD candidate, School of Pharmacy, Virginia Commonwealth University, at the time the study was conducted; currently Manager and Research Scientist, Avalere Health LLC, Washington, DC


Objective  To assess the impact of an appointment-based medication synchronization (ABMS) program on medication adherence and persistence with chronic medications.

Design  Quasiexperimental study in which study patients were matched with control patients.

Setting  Rural pharmacies in the Midwestern United States between June 30, 2011, and October 31, 2012.

Patients  Individuals receiving at least two refills for one of six categories of medications to treat chronic diseases (i.e., angiotensin-converting enzyme inhibitors or angiotensin receptor blockers, beta blockers, dihydropyridine calcium channel blockers, thiazide diuretics, metformin, statins).

Intervention  Patients in the ABMS program were compared with control patients receiving usual care.

Main outcome measures  1-year adherence rates using proportion of days covered (PDC) and 1-year nonpersistence rates.

Results  Depending on the drug class, patients enrolled in the medication synchronization program (n = 47–81) had adherences rates of 66.1% to 75.5% during 1 year versus 37.0% to 40.8% among control patients. Program patients had 3.4 to 6.1 times greater odds of adherence compared with control patients. Control patients were 52% to 73% more likely to stop taking their chronic medications over 1 year.

Conclusion  An ABMS program in community pharmacies was associated with improved patient adherence and reduced likelihood of nonpersistence.

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