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Health Aff (Millwood). 2018 Jan;37(1):125-133. doi: 10.1377/hlthaff.2017.0881.

Medication Synchronization Programs Improve Adherence To Cardiovascular Medications And Health Care Use.

Author information

1
Alexis A. Krumme ( akrumme@bwh.harvard.edu ) is a research scientist in the Division of Pharmacoepidemiology and Pharmacoeconomics, Brigham and Women's Hospital, in Boston, Massachusetts.
2
Robert J. Glynn is a professor of medicine at Harvard Medical School, in Boston, Massachusetts.
3
Sebastian Schneeweiss is a professor of medicine at Harvard Medical School, a professor in epidemiology at Harvard School of Public Health, and vice chief of the Division of Pharmacoepidemiology and Pharmacoeconomics at Brigham and Women's Hospital.
4
Joshua J. Gagne is an associate professor of medicine at Harvard Medical School and a pharmacoepidemiologist in the Division of Pharmacoepidemiology and Pharmacoeconomics, Brigham and Women's Hospital.
5
J. Samantha Dougherty is senior director of policy and research at Pharmaceutical Research and Manufacturers of America (PhRMA), in Washington, D.C.
6
Gregory Brill is a statistical programmer in the Division of Pharmacoepidemiology and Pharmacoeconomics, Brigham and Women's Hospital.
7
Niteesh K. Choudhry is a professor of medicine at Harvard Medical School, an associate physician in the Division of Pharmacoepidemiology and Pharmacoeconomics, Brigham and Women's Hospital, and executive director of the Center for Healthcare Delivery Sciences, Brigham and Women's Hospital.

Abstract

Medication synchronization programs based in pharmacies simplify the refill process by enabling patients to pick up all of their medications on a single visit. This can be especially important for improving medication adherence in patients with complex chronic diseases. We evaluated the impact of two synchronization programs on adherence, cardiovascular events, and resource use among Medicare beneficiaries treated between 2011 and 2014 for two or more chronic conditions-at least one of which was hypertension, hyperlipidemia, or diabetes. Among nearly 23,000 patients matched by propensity score, the mean proportion of days covered (a measure of medication adherence) for the control group of patients without a synchronization program was 0.84 compared to 0.87 for synchronized patients-a gain of 3 percentage points. Adherence improvement in synchronized versus control patients was three times greater in patients with low baseline adherence, compared to those with higher baseline adherence. Rates of hospitalization and emergency department visits and rates of outpatient visits were 9 percent and 3 percent lower in the synchronized group compared to the control group, respectively, while cardiovascular event rates were similar. Synchronization programs were associated with improved adherence for patients with cardiovascular disease, especially those with low baseline adherence.

KEYWORDS:

Adherence; Cardiovascular disease; Medicare; Medication synchronization

PMID:
29309231
DOI:
10.1377/hlthaff.2017.0881
[Indexed for MEDLINE]

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