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Monthly Pharmacist Appointments Improve Medication Adherence

Pills in a prescription bottle (


Researchers at Virginia Commonwealth University in Richmond found regular monthly appointments with pharmacists can help patients keep taking their medications as prescribed. Pharmacy professor David Holdford and then-doctoral candidate Timothy Inocencio published their findings in the current issue of the Journal of the American Pharmacists Association (subscription required).

A study published earlier this year in Journal of the American Medical Association estimates 30 to 50 percent of adults in the U.S. are not keeping current with their medications, adding some $100 billion per year in preventable medical costs. The problem, say the authors, is complex, requiring much the same approach as a diagnosable and treatable medical condition.

Holdford and Inocencio note that effective interventions for improving medication adherence are those that are individualized to the patients, combining various strategies that include improved access to medications, education, reminders, self-monitoring, feedback, and mutual problem solving. Among the methods suggested to solve the problem is standardizing medication schedules to simplify and synchronize medication refills so they come due on a single day of the month.

The researchers tested one such method, known as appointment-based medication synchronization that adds in monthly appointments with the pharmacists to streamline the refill process and resolve medication-related issues. Patients at rural community pharmacies in the Midwest took part in the study, all of whom were prescribed at least one medication from among  six types of drugs for chronic conditions, such as metformin for diabetes or statins to control cholesterol.

The study matched patients taking part in monthly pharmacist synchronization appointments with similar patients in a control group prescribed the same kinds of drugs and receiving the usual care, numbering about 50 to 80 patients for each class of drugs. The researchers then measured adherence rates for the patients and their medications over one-year periods from July 2011 through October 2012.

Holdford and Inocencio found patients participating in appointment-based medication synchronization had adherence rates of 66 to 76 percent over the course of one year, compared to 37 to 41 percent for patients in the control group. Patients in the test program were also 3 to 6 times more likely to keep to their medication schedules than their counterparts in the control group. In addition, control group patients were 52 to 73 percent more likely to stop taking their medications over the one-year period.

“This research shows appointment-based medication synchronization to be one of the most effective interventions available to help patients take their medications,” says Holdford in a university statement. “Widespread implementation in pharmacies across the U.S. can have a major impact on patient health.”

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