Pharmacy's Appointment Based Model
Medication Synchronization Align My Refills
The Appointment Based Model (ABM) is a patient care service designed to improve patients’ adherence to medications and build efficiencies in pharmacy operations. Each patient enrolled in the ABM has a designated appointment day to pick up all medications. Pharmacy staff call patients in advance of their appointment to identify any changes to the medications and confirm that each prescription should be refilled. The model can be implemented in any pharmacy setting to improve patients’ medication adherence, to build efficiency into pharmacy workflow, and to manage potential issues before the patient arrives at the pharmacy to pick up their medicines.
The ABM shifts the pharmacy staff’s focus from passively filling prescription orders at the request of the patient on an unaligned schedule to proactively synchronizing a pick-up date for chronic medicines and confirming the patient is receiving the correct medications each month. In the ABM, pharmacists and pharmacy staff are able to perform a full review of all medications each month, which provides the opportunity to identify therapeutic and compliance issues that patients may be encountering.
To gather an expert panel of individuals who have experience designing and implementing innovative methods to improve medication adherence, especially through appointment-based models and refill synchronization.
The APhA Foundation gathered a consortium of stakeholders together on January 9-10, 2013, in Washington, D.C., to synthesize the expert panel’s experiences related to designing and implementing innovative methods to improve medication adherence, especially through appointment based models and refill synchronization. Participants represented 11 community pharmacies or pharmacy networks, 3 national organizations, and 2 government agencies. Six consortium participants were affiliated with organizations that are currently operating or exploring the ABM. The resulting white paper, titled “Pharmacy’s Appointment Based Model: a prescription synchronization program that improves adherence,” describes benefits and implementation requirements of the ABM that were highlighted at the consortium meeting and within published literature.
The ABM shifts the pharmacy staff’s focus from passively filling prescription orders at the request of the patient on an unaligned schedule to proactively synchronizing a pick-up date for chronic medicines and confirming the patient is receiving the correct medications each month. In the ABM, pharmacists and pharmacy staff are able to perform a full review of all medications each month, which provides the opportunity to identify therapeutic and compliance issues that patients may be encountering.
Goal
Consortium Participants
John Beckner Giant Pharmacy Kristen Betts Centers for Disease Control and Prevention Bob Egeland Hy-Vee Stephen Giroux Middleport Family Health Center Peter Koo Bartell Drugs Jessica Lee Kerr Drug Dan Luce Walgreens Jesse McCullough Rite Aid Thomas Menighan American Pharmacists Association Robert Narveson Thrifty White Pharmacy James Owen APhA [e-HIT Collaborative] Pete Ratycz Discount Drug Mart Lee Rucker AARP Public Policy Institute Robin Sistrunk Publix John Sykora Abrams & Clark Pharmacy Lisa Tonrey USPHS Indian Health Service Eleanor Twigg Fred's Pharmacy George Vuturo RxAlly
Pfizer Representatives
David Searle Pfizer Walt Slijepcevich Pfizer
APhA Foundation Staff
Benjamin Bluml APhA Foundation Caroline Shedlock APhA Foundation Mindy Smith APhA Foundation Lindsay Watson APhA Foundation Krystal Weaver APhA Foundation
Implementation Guide and Customizable Resources
The white paper provides implementation considerations for the methods and infrastructure needed to successfully start and grow the ABM in a community pharmacy setting. The APhA Foundation utilized the consortium recommendations to refresh an ABM Implementation Guide, previously developed by the Alliance for Patient Medication Safety. The ABM Implementation Guide and accompanying customizable resources are available below and will help pharmacist and community pharmacy administration navigate through the process of integrating the ABM into pharmacy workflow and business models.
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Pharmacy's Appointment Based Model: a Prescription Synchronization Program that Improves Adherence
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Pharmacy's Appointment Based Model - Implementation Guide for Pharmacy Practices
ACO Demonstration Project
The APhA Foundation is partnering with an accountable care organization (ACO), community pharmacy chain, and federally qualified health center in Tucson, AZ, in an effort to demonstrate the impacts the ABM can have on adherence for patients of an ACO. The collection of data is essential to the success of the project, and with the input of the ACO and partners, the APhA Foundation has established a minimum data set that will be collected from the various partners throughout the duration of the project. The ABM process will be studied for a minimum of six months. This project began in the fall of 2013 and is ongoing.
ABM Reports from the Alliance for Patient Medication Safety:
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Patient Centric Model Pilot Data Analysis Report - April 2011
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The Appointment Based Model: Project Results and Next Steps - March 2011
Looking to the Future
The ABM has strong potential to transform health care through significant improvements to medication adherence and optimization of pharmacy workflow. To see evidence of the ABM's positive impact on medication adherence, read this article published in JAPhA about a study conducted on patients served by ThriftyWhite Pharmacy, a chain of employee-owned community pharmacies located in several rural Midwestern U.S. states. The results show a promising outlook on how the ABM can be implemented to help pharmacists better meet patient needs.
you can pick up all of your medications at once. Med Sync eliminates the need to call in multiple prescription refills, allows you the convenience of fewer trips to the pharmacy, and provides an opportunity to meet with your pharmacist on a monthly basis to discus your medications.
Align My Refills
A simple solution for taking your medications as prescribed
Approximately 69 million Americans take three or more prescriptions per month, requiring multiple trips to the pharmacy. Many consumers say they miss doses of their medication because they forget to refill their prescription before they run out.
Missed or skipped doses of medication cause 125,000 deaths every year and account for 10 to 25 percent of hospital and nursing home admissions.
Medication synchronization is a simple service where the pharmacy coordinates your prescription refill schedule so
See how a med sync program works and get answers to frequently asked questions.
HOW IT WORKS
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Talk to your pharmacist about enrolling in med sync.
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Once enrolled, pharmacy staff will review your ongoing monthly medications and develop a plan to synchronize them so they can be picked up on a single day each month that is convenient for you.
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Pharmacy staff may call you to confirm your pick up date about a week prior and identify any necessary changes that should take place before your prescriptions are filled.
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After reviewing any changes to your medications, the pharmacy staff will prepare each prescription and create one package for easy pick up on your scheduled date.
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On your scheduled day, you pick up all of your prescriptions at the pharmacy. At that time, you can ask the pharmacist any questions that you may have about your medication.
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The process repeats itself each month so that you can pick up all of your medications at once, and the pharmacist can identify potential issues to help you take your medication as prescribed.
Frequently Asked Questions
Q. Who is best suited for medication synchronization? A. Medication synchronization is most helpful for patients taking multiple, ongoing monthly medications, the elderly, and patients new to chronic drug therapy. Q. Why should I care about synchronizing my medications? A. One-third of consumers have missed a dose of their medication because they didn't refill their prescription before it ran out. If you are not taking your medication as prescribed or missing or skipping doses, it can have serious side effects on your health including death. Through med sync, the pharmacist proactively refills your prescription so that you don't have to remember to call the pharmacy and they work closely with you to make sure that your medications are working for you and being taken properly. Q. Will there be an additional cost or monthly fees? A. Generally, there is no additional cost to you. The goal of med sync is for the pharmacist to synchronize your medications in the most convenient and cost efficient manner for you. Often times, the pharmacist will dispense a shorter or longer supply of medication for your first med sync pick up so that you can maintain your insurance coverage. It is best to ask your pharmacist about their strategy for synchronizing your medication. Q. Will appointments be on a specific day? And at a specific time? A. Pharmacists will work with you to determine a day that is convenient each month. You do need to pick up your prescriptions on that particular day in order for the program to be successful. Typically, your pick up will not be at a specific time unless you chose and depending on the availability of your pharmacist. Q. Should I let my physician know that I am participating in a med sync program? A. Yes, med sync has a positive influence on the relationship between you, your pharmacist, and your physician. Through med sync, you can all work together to improve your health. If your pharmacist identifies any issues during their monthly review of your medications, they can work with your physician on a solution. Q. Will all of my medications be included if I chose to participate in a med sync program? A. Not necessarily. There are some medications that are not appropriate for a med sync program, such as antibiotics, ointments, eye drops, and "as-needed" medications for pain. Q. How many pharmacies are offering medication synchronization programs? A. More than 5,000 pharmacies are offering med sync programs, but that number continues to grow. Ask your pharmacist if they offer a med sync program or if they can work with you to streamline your medications. Med sync is just one way that your pharmacist can help you improve your medication use - your pharmacist is an incredibly valuable resource for managing your health.
Benefits to Patients and Caregivers
Medication synchronization has multiple benefits that make the pharmacy experience easier for patients taking multiple medications and their family members or caregivers. These benefits have a strong impact on helping people take their medication as prescribed, which contributes to their better health.
Taking your medication as directed by your health care providers including your pharmacist is known as medication adherence. Many people are non-adherent to their medications, meaning they might either skip a dose, stop taking their medication, or never fill their prescription. This ongoing problem in America has contributed to billions of dollars in healthcare spend, chronic disease complications, and even deaths. If you or someone you know take ongoing monthly medications and are having trouble sticking to your medication regimen, enrolling in a med sync program at your local pharmacy can help you manage your medications and feel better.
Peace of Mind: Your likelihood of missing doses because you forgot to refill your prescription decreases dramatically. Your pharmacy is responsible for proactively coordinating when your prescription needs to be refilled.
Convenience: You will pick up all of your medications in one trip to the pharmacy per month. This will eliminate the need for you to make time in your busy schedule for multiple refill calls and visits to the pharmacy.
Improved medication management: You will develop a closer relationship with your pharmacist during your monthly pick-up, leading to a better understanding of how your medication therapy works and how you can avoid side effects.
These benefits will allow you to successfully navigate your medication regimen with the help of your pharmacist. Taking your medications properly improves health outcomes and makes people feel healthier. The pharmacist will also be able to work with your health care provider if they become aware of any issues through their review of your medications and your monthly visits.
Med sync is just one way to improve your medication adherence. If you are looking for additional resources on medication adherence, visit BeMedicineSmart, an initiative of the National Council on Patient Information and Education.
