Lin Qiqi, Mathers Annalise, Tilli Tiana, Baker Jen, Bhaidani Saleema, Grootendorst Paul, Cadarette Suzanne M, Dolovich Lisa
Leslie Dan Faculty of Pharmacy, University of Toronto, Toronto, Ontario, Canada.
WholeHealth Pharmacy Partners, Markham, Ontario, Canada.
Res Social Adm Pharm. 2023 Sep;19(9):1286-1291. doi: 10.1016/j.sapharm.2023.05.011. Epub 2023 May 28.
Traditionally, much of community pharmacy practice relies on patients to request their own medication refills. These refills are often not aligned, which has been shown to decrease adherence and workflow efficiencies. The appointment-based model (ABM) is designed to proactively synchronize refills and schedule patient-pharmacist appointments.
To describe the characteristics of patients enrolled in the ABM; and to compare the number of distinct refill dates, number of refills, and adherence for antihypertensives, oral antihyperglycemics, and statins 6-months and 12-months pre-post ABM implementation.
In September 2017, the ABM was implemented across independent community pharmacies within a pharmacy banner in Ontario, Canada. In December 2018, a convenience sample of three pharmacies was extracted. Demographic and clinical characteristics were collected on program enrollment (index) date for individual patients and their medication fill histories were used to investigate adherence measures including distinct number of refill dates, number of refills, and proportion of days covered. Descriptive statistics were analyzed using StataCorp.
Analysis of 131 patients (48.9% male; mean age 70.8 years ± 10.5 SD) filled on average 5.1 ± 2.7 medications with 73 (55.7%) experiencing polypharmacy. Patients had a significant reduction in mean number of refill dates (6.8 ± 3.8 SD six-months pre-enrollment, 4.9 ± 3.1 SD six-months post-enrollment, p < 0.0001). Adherence to chronic medications remained high (PDC ≥95%).
The ABM was implemented for a cohort of established users, already highly adherent to their chronic medications. Results demonstrate reduced filling complexity and fewer refill dates while also sustaining the high baseline adherence across all chronic medications studied. Future studies should investigate patient perspectives and potential clinical benefits of the ABM.
传统上，社区药房的许多业务依赖患者自行要求补充药物。这些药物补充往往不一致，这已被证明会降低依从性和工作流程效率。基于预约的模式（ABM）旨在主动同步药物补充并安排患者与药剂师的预约。
描述参与ABM的患者特征；比较ABM实施前后6个月和12个月时，抗高血压药、口服降糖药和他汀类药物的不同补充日期数量、补充次数以及依从性。
2017年9月，ABM在加拿大安大略省一家药房旗下的独立社区药房中实施。2018年12月，抽取了三家药房的便利样本。在个体患者的项目登记（索引）日期收集人口统计学和临床特征，并利用他们的用药记录来调查依从性指标，包括不同的补充日期数量、补充次数以及覆盖天数的比例。使用StataCorp进行描述性统计分析。
对131名患者（48.9%为男性；平均年龄70.8岁±10.5标准差）进行分析，他们平均服用5.1±2.7种药物，其中73人（55.7%）患有多种药物治疗。患者的平均补充日期数量显著减少（登记前6个月为6.8±3.8标准差，登记后6个月为4.9±3.1标准差，p<0.0001）。对慢性药物的依从性仍然很高（连续服药率≥95%）。
ABM是为一群已经高度依从其慢性药物治疗的既定用户实施的。结果表明，用药复杂性降低，补充日期减少，同时在所有研究的慢性药物中保持了较高的基线依从性。未来的研究应调查患者对ABM的看法以及潜在的临床益处。
