By appointment only: Could this model be a game changer for your pharmacy?

An appointment-based model in pharmacy can make life easier for patients by reducing the frequency of prescription pickups and help maintain—and potentially improve—medication adherence while ensuring they get appropriate counselling from their pharmacist. Pharmacies, in the meantime, could gain from more efficient workflows and more prescriptions filled and refilled. These are the key finding from a recent study of 131 patients enrolled in appointment-based programs at three independent community pharmacies in Ontario. “In current pharmacy practice, patients taking several medicines typically request prescription refills of their medications on an unaligned schedule, which can impact pharmacy workflow efficiency, resulting in longer wait times for the patient, and less opportunity for pharmacists to provide clinical services,” wrote the study authors. “The need for a patient to visit a pharmacy multiple times each month to refill their medications can also contribute to lower adherence … developing and implementing programs and strategies to proactively tackle the problem of medication non-adherence are critical to improve individual well-being and medication management as well as healthcare system efficiency.” Read: It's time to explore pharmacy as the hope of healthcare Led by pharmacist researchers at the University of Toronto and Whole Health Pharmacy Partners, the study analysed 15 months of the patients’ refill data for three types of medications: antihypertensives, oral antihyperglycemics and statins. The patients—which had a mean age of 71 years and an almost even split of males and females—were taking just over five medications on average and more than half were taking five or more medications. As part of the appointment-based program, the medications for these patients were synchronized so that refill due dates were aligned, allowing patients to pick up their prescriptions at predetermined time intervals. For the study, these refill dates were used as a marker for the number of times a patient would have picked up their prescription from a pharmacy. The program also scheduled appointments for these pickups to create opportunities for patients to receive one-on-one counselling from their pharmacist. Read: Bridgewater Guardian Pharmacy goes out of its way for patients Researchers found that the program led to a significant reduction in the mean number of distinct refill due dates from about seven times during the six months before implementation of the program to just under five during the six months after implementation. Over a 12-month period, the mean number of distinct refill dates decreased from close to 13 pre-implementation to seven post-implementation. “(Appointment-based models) can make accessing important medications easier, circumventing the risk of nonadherence due to access issues and inconvenience,” wrote the authors. “In addition, for some patients, fewer trips to the pharmacy not only saves money but also transportation-related costs.” The study also looked at the number of refills—or how many times any medication on a patient’s profile was filled or refilled—and found an increase from 12 to just over 13 during the six months pre- and post-implementation. Read: Techs play vital role in minor ailment prescribing Researchers did not find a significant difference in medication adherence because the patients in the study were already at high levels of adherence. The study did observe that the patients maintained high adherence. The appointment-based model was created in 1995 by a pharmacist in California named John Sykora. Over recent decades, according to the study authors, a growing number of community pharmacies and pharmacy networks in the United States have adopted this model. The researchers cited the model’s “enormous potential to incorporate virtual approaches to medication care to meet the needs of high-risk patients and those who are unable to visit a pharmacy in person.” At the same time, the predictable workflow resulting from the model “may help pharmacists better manage inventory, personnel, and delivery costs, as well as create increased opportunities for scheduled billable services that could both offer a benefit to patients and increase revenue for the pharmacy. Read: 10 technology innovations changing pharmacy

By appointment only: Could this model be a game changer for your pharmacy?

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