Prescription Refill Synchronization May Solve Adherence Dilemma

Medication adherence is an ongoing issue that costs the health care system hundreds of billions of dollars.

However, in a recent study, the use of a refill synchronization program was found to increase adherence by more than 10%. Currently, medication synchronization programs are available in nearly 2 dozen pharmacy chains, and more than 2000 independent pharmacies in the United States.

Unfortunately, little research has been done of the efficacy of these programs. In a study published in Health Affairs, researchers enrolled 691 Medicare patients into a synchronized refill program who were receiving 2 to 6 oral medications for diabetes, high blood pressure, or high cholesterol through a mail-order pharmacy.

The synchronized refill program involved pharmacists adjusting the participants’ prescription schedules so that all of their medications would be available for refill on the same day. Researchers tracked medication adherence for 12 months before and after enrollment into the program, and compared it to a control group of 695 Medicare patients who received usual care from their mail-order pharmacy, which included automated reminders about refills, but not the synchronization of refills.

The results of the study showed that on average, participants in the synchronized refill program increased medication adherence between 3% and 5% over the control group. Most notably, the program had even greater effects among patients who had the lowest levels of adherence prior to the intervention.

This group of patients improved adherence by 9% to 13% over the control group.

“The logistical challenges involved with keeping track of remaining pills and obtaining timely refills and renewals are magnified for patients who need to take multiple medications, and often create an obstacle to medication adherence,” said lead study author Jalpa A. Doshi, PhD. “Based on the results of our study, synchronized prescription programs that adjust medication refill dates so that all prescriptions are ‘due’ for a refill at the same time may be an effective strategy to reducing these obstacles.”

Although these findings provide additional information on synchronized refill programs, further research needs to be conducted.

“Previous research has shown a direct correlation between medication adherence and improved health outcomes, but future studies are needed to examine whether synchronized refill programs are associated with changes in health outcomes, as well as the economic impact of such programs,” said senior study author Kevin Volpp, MD, PhD.

Researchers noted that although the program targets several logistical obstacles, it is not able to target other common causes of adherence alone, such as ambivalence to taking medications and forgetting doses.

“Nevertheless, prescription synchronization can be combined with other types of interventions, based on a patient’s specific adherence challenges to further enhance medication adherence,” Doshi said.