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JAPhA: The Impact of Medication Synchronization Programs on Medication Adherence: A Meta-Analysis

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Published:February 16, 2021DOI: https://doi.org/10.1016/j.japh.2021.02.005

Abstract

Background

Medication nonadherence is associated with more than $100 billion in preventable medical costs each year in the United States. Medication synchronization (med sync) programs have emerged as a potential solution to addressing nonadherence.

Objectives

To assess the impact of med sync programs on adherence in adults on chronic medications through a meta-analysis.

Methods

A comprehensive literature search was conducted for studies of med sync and adherence in adults published in English from database inception to May 2020. Studies were included if they provided a description of the med sync program, reported a quantitative measure of medication adherence using the proportion of days covered metric, and were conducted in the United States. Search terms included “medication synchronization”, “med sync”, “adherence” and “PDC”. Pooled odds ratios (OR) and 95% confidence intervals (CI) using random-effects models were calculated to assess overall impact and subgroup analyses. Risk of bias for individual studies were assessed using the Downs & Black checklist.

Results

Nine studies reporting 30 effect sizes were included in the meta-analysis. Based on the Downs & Black checklist, the methodological quality of the studies was fair [mean (SD) 17.6(1.7)]. Med sync was associated with greater odds of adherence (pooled OR = 2.29, 95% CI 1.99, 2.64, I 2 = 93.3%; τ 2 = 1.11). In addition, the type of med sync program influenced the variation in effect sizes [Cochran’s Q statistic (Q between) = 45.4, p<.0001], with appointment-based med sync (ABMS) programs having the largest impact on adherence (pooled OR = 3.14; 95% CI: 2.72, 3.63).

Conclusion

In this meta-analysis of the impact of med sync on adherence, med sync was associated with significant improvement in adherence. Policy makers and payers should consider reimbursement to pharmacies to support med sync programs in efforts to combat medication nonadherence and improve health outcomes.CONTINUE READING … | DOWNLOAD … SOURCE: https://www.japha.org/article/S1544-3191(21)00073-X/pdf&nbsp;

Article Info

Publication History

Accepted: February 12, 2021Received in revised form: January 15, 2021Received: October 26, 2020

Publication stage

In Press Journal Pre-Proof

Footnotes

Author Contribution

Irene Nsiah: Conceptualization, Data curation, Formal analysis, Investigation, Methodology, Project administration, Software, Validation, Visualization, Writing – original draft , Writing – review and editing Hyllore Imeri: Data curation, Investigation, Project administration, Software, Validation, Visualization, Writing – original draft , Writing – review and editing Avery Claire Jones: Data curation, Investigation, Software, Validation, Writing – review and editing John Bentley: Conceptualization, Formal analysis, Methodology, Resources, Supervision, Writing – review and editing Marie Barnard: Data curation, Formal analysis, Investigation, Methodology, Resource, Software, Supervision, Writing – review and editing Minsoo Kang: Conceptualization, Formal analysis, Methodology, Resources, Software, Validation, Visualization, Writing – review and editing

Funding support: This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors

Disclosures of conflicts of interest: The authors declare no relevant conflicts of interest or financial relationships.

Previous presentations of the work: None

Key points

What was already known

•Medication nonadherence is a significant public health issue associated with morbidity, mortality and healthcare costs. Medication synchronization (med sync) programs in pharmacies have emerged as a potential solution to nonadherence.

•Several individual quantitative studies have been conducted to examine the association between med sync and adherence.

•However, differences in study design, med sync program designs, and sample sizes translate into diverse effect magnitudes of med sync on adherence across the studies.

What this study adds

•Through a meta-analysis, this study quantifies the overall impact of med sync on adherence and examines the effect of different types of med sync programs on adherence.

•Overall, med sync is associated with significantly higher odds of adherence, with the appointment-based med sync program having the largest impact.

Identification

DOI: https://doi.org/10.1016/j.japh.2021.02.005

Copyright

© 2021 Published by Elsevier Inc. on behalf of the American Pharmacists Association.

ScienceDirect

Access this article on ScienceDirect

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