Multimed Packaging Shown to Improve Medication Adherence

An improvement in clinical outcomes and medication adherence rates when patients used medication therapy management (MTM) services and multimed blister card packaging was clearly shown in a recent study announced by Omnicell.

The randomized clinical trial, STOMPP (Study to Measure the Impact of Pharmacists and Pharmacy Services on Medication Non-Adherence), compared the use of adherence medication packaging and MTM services to the use of traditional pill bottles.

During the 1-year study, patients were randomly assigned to 1 of 4 groups, based on how their medications were dispensed, in multimed blister packaging or vials, and whether they had received pharmacist-provided MTM services. Study participants who received multimed blister cards had the most marked change in adherence scores compared with pill bottle groups, achieving greater than 45% above baseline. Adherence improvements with the use of MTM services and multimed packaging were proven individually, and in combination.

Almost immediately, patients assigned to the multimed packaging groups reached medication adherence rates of 80%, and they reached 90% adherence rates by the conclusion of the trial. By contrast, patients assigned to the pill bottle-only group reached a maximum adherence rate of 56% by the study’s end.

Nonadherence to medications for treating chronic conditions is associated with higher rates of hospital admissions, suboptimal health outcomes, increased morbidity and mortality, and higher health care costs, according to the CDC.

The CDC estimates that direct health care costs associated with nonadherence is about $300 billion annually in United States.

The individuals studied in STOMPP had all been diagnosed with hyperlipidemia, hypertension, and/or type 2 diabetes. Most of the participants had a body mass index of more than 30, were taking about 10 medications, and had uncontrolled diabetes with HbA1c greater than 7%. The study also assessed clinical outcome measures, quality of life, and cost and utilization data.

Funded by an unrestricted grant from Omnicell, STOMPP also found that patients who received multimed packaging reached blood pressure goals sooner than those who did not use that same type of packaging. In addition, study participants who received MTM and multimed packaging had the lowest HbA1c values at year’s end of all the groups.

By contrast, patients who only received medication in pill vials with no other pharmacy-based services incurred higher costs, had the poorest health outcomes, and used more patient resources than trial participants in other groups.

“Our pharmacy partners know the impact they can have on patient care when they’re able to offer additional resources to their patients. The STOMPP study formalizes what we have known as an industry for years and allows these providers to advocate for a greater involvement in patient care teams moving forward,” Rob Seim, president of Global Automation and Medication Adherence for Omnicell, said in a statement.

The CDC also touts the use of blister packs and pill boxes that organize medications, as a cost-effective, proven strategy for reducing unintentional nonadherence.

In addition, coordinated or team-based care have been shown to increase adherence rates, according to the CDC.

Proven methods include collaborative care between pharmacists and primary-care providers, pharmacist-led medication reconciliation and tailoring, and pharmacist-led patient education.

Sharrel Pinto, BS, PharmD, DMM, MS, PhD, the study’s principal investigator and lead researcher, also said that the STOMPP results reinforce the adherence pharmacy model, and he affirmed the value of pharmacists as a key member of the health care team.

“As a nation, we need to do a better job at managing complex patients, as 80 million patients are expected to have more than 1 chronic condition by 2030,” she said in a statement. “Using the arsenal of tools now available to this industry, including medication synchronization technology, and blister packaging, pharmacists can help patients significantly impact their health.”

References

• STOMOPP study demonstrates multimed packaging improves medication adherence [news release]. Mountain View, CA: June 12, 2018; Omnicell. omnicell.com/News_and_Events/Press_Releases/STOMPP_Study_Demonstrates_Multimed_Packaging_Improves_Medication_Adherence.aspx. Accessed June 20, 2018.
• Neiman AB, Ruppar T, Ho M, et al. CDC Grand Rounds: improving medication adherence for chronic disease management - innovations and opportunities. MMWR Morb Mortal Wkly Rep. 2017;66. 2017;66(45):1248-1251. doi: 10.15585/mmwr.mm6645a2.