Department Clinical Pharmacy and Translational Science at the University of Tennessee Health Science Center College of Pharmacy, Memphis, TN, USA.
Assistant Member at Moffitt Cancer Center and an Assistant Professor at the University of South Florida Morsani College of Medicine, Tampa, FL, USA.
Res Social Adm Pharm. 2021 Aug;17(8):1496-1500. doi: 10.1016/j.sapharm.2020.11.009. Epub 2020 Nov 19.
While medication synchronization programs are becoming a staple in community pharmacies, a standard process needs to be identified to provide consistent positive outcomes. Many studies demonstrate how medication synchronization affects individual level patients but have not examined how medication synchronization affects the pharmacy's performance. Because community pharmacies are calibrated based on performance to adherence measures for all patients, it is important to understand whether resource-intensive interventions, such as medication synchronization, lead to improved performance.
The aims of this study were to 1) examine pharmacy characteristics associated with medication synchronization adoption and 2) examine whether medication synchronization is associated with pharmacy-level performance on select medication adherence and utilization measures.
This study used a cross-sectional design. Community pharmacies participating in the North Carolina Community Pharmacy Enhanced Services Network (NC CPESN℠) program were included in this study. Pharmacy performance was measured as summary score of pharmacy's performance on seven risk-adjusted measures which were used to measure pharmacy's performance in the program. Adoption of medication synchronization was measured as a binary variable capturing whether the pharmacy offered med sync at the time the survey was administered.
Surveys were received from 160 out of 268 participating pharmacies (59.7% response rate) with a total of 155 pharmacies being included in the analytic sample. Pharmacies that adopted medication synchronization were more likely to have a clinical pharmacist on staff (c = 5.4, p = 0.019). Holding all else constant, medication synchronization adoption was not significantly associated with total medication adherence performance (p = 0.371).
Medication synchronization has proven successful in improving individual patient level adherence but may not change a pharmacy's overall performance in adherence for all patients. Further research is needed to examine how effective implementation might contribute to whether a medication synchronization program leads to meaningful gains in adherence for all patients.
虽然药物同步计划正在成为社区药房的主要内容,但需要确定一个标准流程,以提供一致的积极结果。许多研究表明药物同步如何影响个体患者,但尚未研究药物同步如何影响药房的绩效。由于社区药房根据所有患者的依从性措施来调整绩效,因此了解资源密集型干预措施(如药物同步)是否会导致绩效提高非常重要。
本研究旨在 1)研究与药物同步采用相关的药房特征,2)研究药物同步是否与特定药物依从性和利用措施的药房级别绩效相关。
本研究采用横断面设计。参与北卡罗来纳州社区药房增强服务网络(NC CPESN℠)计划的社区药房被纳入本研究。药房绩效通过七个风险调整措施的药房绩效综合得分来衡量,这些措施用于衡量药房在该计划中的绩效。药物同步的采用被测量为一个二进制变量,捕捉药房在进行调查时是否提供药物同步服务。
从 268 家参与药房中收到了 160 份调查(59.7%的响应率),共有 155 家药房被纳入分析样本。采用药物同步的药房更有可能有临床药剂师在员工中(c=5.4,p=0.019)。在其他因素不变的情况下,药物同步采用与总体药物依从性绩效无显著相关性(p=0.371)。
药物同步已被证明在提高个体患者的依从性方面非常成功,但可能不会改变药房对所有患者的整体依从性绩效。需要进一步研究如何有效实施,以确定药物同步计划是否会导致所有患者的依从性有意义的提高。