Adherence and persistence associated with an appointment-based medication synchronization program

J Am Pharm Assoc (2003). 2013 Nov-Dec;53(6):576-83. doi: 10.1331/JAPhA.2013.13082.


Objective: To assess the impact of an appointment-based medication synchronization (ABMS) program on medication adherence and persistence with chronic medications. DESIGN Quasiexperimental study in which study patients were matched with control patients.

Setting: Rural pharmacies in the Midwestern United States between June 30, 2011, and October 31, 2012.

Patients: Individuals receiving at least two refills for one of six categories of medications to treat chronic diseases (i.e., angiotensin-converting enzyme inhibitors or angiotensin receptor blockers, beta blockers, dihydropyridine calcium channel blockers, thiazide diuretics, metformin, statins).

Intervention: Patients in the ABMS program were compared with control patients receiving usual care.

Main outcome measures: 1-year adherence rates using proportion of days covered (PDC) and 1-year nonpersistence rates.

Results: Depending on the drug class, patients enrolled in the medication synchronization program (n = 47-81) had adherences rates of 66.1% to 75.5% during 1 year versus 37.0% to 40.8% among control patients. Program patients had 3.4 to 6.1 times greater odds of adherence compared with control patients. Control patients were 52% to 73% more likely to stop taking their chronic medications over 1 year.

Conclusion: An ABMS program in community pharmacies was associated with improved patient adherence and reduced likelihood of nonpersistence.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Aged, 80 and over
  • Chronic Disease
  • Community Pharmacy Services / organization & administration*
  • Female
  • Humans
  • Male
  • Medication Adherence*
  • Middle Aged
  • Pharmaceutical Preparations / administration & dosage*
  • Rural Health Services / organization & administration
  • Time Factors


  • Pharmaceutical Preparations