Synchronized dosing

As a pharmacist, Sam Stolpe believes his profession can make a sizable difference in the persistent problem of patient nonadherence to drug regimens. He has more than just pride in his profession on his side—study data backs him up.

And packaging engineers can help, because he sees compliance-style packaging as part of the solution.

Stolpe is associate director, quality initiatives, for the Pharmacy Quality Alliance, a consensus-driven organization developing quality measures used in the Medicare Part C and D five-star ratings program. Healthcare insurers are paying close attention to such quality ratings because those insurers that are found to provide high-quality plans may receive quality bonus payments. And now there are disincentives for those plans that perform consistently low.

Several quality measures within the star ratings relate to patient adherence. “More plans are looking for solutions to medication nonadherence,” says Stolpe.

One approach that Stolpe advocates is the appointment-based model (ABM), and he will explain the approach at the upcoming RxAdherence 2014 April 8 in "Medication Synchronization in the Emerging Quality Landscape." The event will be in Florham Park, NJ.

Three core elements of ABM are synchronization of chronic medications so that they all fall due on the same day; aligning refill dates with appointments that become the focal point between the healthcare provider, the pharmacy, and the patient; and preappointment calls 5 to 7 days before in which the pharmacist identifies any changes in medication or patient health and behavior, Stolpe explains. “As a trusted, high-touch healthcare professional, pharmacists are uniquely positioned to support patients in safe and appropriate medication behaviors. And with pharmacists seeking provider status, that indicates a willingness to embrace accountability. Taking responsibility for medication adherence is a huge opportunity for pharmacists.”

Medication synchronization has been shown to make a difference. “One study from Virginia Commonwealth University shows that medication synchronization can result in 84 additional days of medication use per year. I have never seen an intervention with this much impact,” Stolpe says. “There is the potential for good patient outcomes.”

Stolpe notes that two grocery chains, Publix and Winn-Dixie, have successfully launched such synchronization programs storewide, and most large pharmacy chains are running pilots. Even the National Community Pharmacists Association is running its “Simplify My Meds” program for independent pharmacies.

“Medication synchronization is poised to become the standard of pharmacy practice within the next 5 to 7 years,” he predicts.

Stolpe sees a “huge opportunity” for compliance packaging, and at RxAdherence he will explore one example of how it is being used as the main driver in a medication synchronization program. “When you want to change quality in a closed system, you should focus on systemic elements, the operational components that drive the quality of that system,” he explains. “ABM facilitates a mindset that helps pharmacists to consider the needs of their patients even when they aren’t standing right in front of them.”

Pharmacists should be managing the medication of patient populations, and not focused on patients strictly as “customers,” he believes.

Click here to learn more about RxAdherence where Stolpe and other speakers exploring medication synchronization and other ways to drive medication adherence.