A Synchronized Prescription Refill Program Improved Medication Adherence

Jalpa A Doshi; Raymond Lim; Pengxiang Li; Peinie P Young; Victor F Lawnicki; Joseph J State; Andrea B Troxel; Kevin G Volpp

doi:10.1377/hlthaff.2015.1456

A Synchronized Prescription Refill Program Improved Medication Adherence

Health Aff (Millwood). 2016 Aug 1;35(8):1504-12. doi: 10.1377/hlthaff.2015.1456.

Authors

Jalpa A Doshi¹, Raymond Lim², Pengxiang Li³, Peinie P Young⁴, Victor F Lawnicki⁵, Joseph J State⁶, Andrea B Troxel⁷, Kevin G Volpp⁸

Affiliations

¹ Jalpa A. Doshi (jdoshi@mail.med.upenn.edu) is an associate professor in the Division of General Internal Medicine, director of the Economic Evaluations Unit in the Center for Evidence based Practice, and director of Value Based Insurance Design Initiatives at the Center for Health Incentives and Behavioral Economics (CHIBE), all at the University of Pennsylvania, in Philadelphia.
² Raymond Lim is a biostatistician at CHIBE, University of Pennsylvania.
³ Pengxiang Li is a senior research investigator in the Division of General Internal Medicine at the University of Pennsylvania.
⁴ Peinie P. Young was a medication adherence program manager for the Humana Pharmacy Solutions Patient Safety Programs at Humana, in Louisville, Kentucky, at the time the study was conducted. She is currently a director of technical marketing for clinical pharmacy products at the Fuse Innovation Lab of Cardinal Health, in Dublin, Ohio.
⁵ Victor F. Lawnicki is a data scientist at Humana.
⁶ Joseph J. State is a business development consultant at Humana.
⁷ Andrea B. Troxel is a professor of biostatistics and associate director of the Division of Biostatistics, Department of Biostatistics, Perelman School of Medicine, and director of biostatistics at CHIBE, all at the University of Pennsylvania.
⁸ Kevin G. Volpp is a professor of medicine in the Department of Medicine at the Perelman School of Medicine and of health care management at the Wharton School, vice chair for health policy in the Department of Medical Ethics and Health Policy, and director of CHIBE, all at the University of Pennsylvania, and a staff physician at the Corporal Michael J. Crescenz VA Medical Center, in Philadelphia.

PMID: 27503977
DOI: 10.1377/hlthaff.2015.1456

Abstract

Synchronizing medication refills-renewing all medications at the same time from the same pharmacy-is an increasingly popular strategy to improve adherence to medication regimens, but there has been little research regarding its effectiveness. In light of increasing policy interest, we evaluated the impact of a pilot refill synchronization program implemented by a large national insurer. A random sample of Medicare Advantage patients receiving mail-order refills for common maintenance medications (antihypertensive, lipid-lowering, or antidiabetic agents) were invited to join the program and followed for twelve months. On average, the absolute increase in the proportion of patients deemed adherent during follow-up was 3-10 percentage points for the intervention group, compared to 1-5 percentage points for the control group. Patients with poorer baseline adherence showed larger increases in the absolute proportion deemed adherent in intervention (23-26 percentage points) compared to a control group (13-15 percentage points). Synchronizing refills might be a promising intervention to improve adherence to maintenance medications, especially among Medicare patients with low baseline adherence.

Keywords: Chronic Care; Medicare; Medication Adherence; Medication synchronization; Pharmaceuticals.

Project HOPE—The People-to-People Health Foundation, Inc.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Aged
Aged, 80 and over
Case-Control Studies
Drug Prescriptions / statistics & numerical data*
Drug Utilization
Female
Humans
Male
Medicare*
Medication Adherence*
Medication Therapy Management / organization & administration*
Program Evaluation
Retrospective Studies
United States