- An appointment-based model (ABM) in the pharmacy can improve patient satisfaction, patient-provider relationships, and adherence to preventive care and vaccinations, according to a study published in the Journal of the American Pharmacist Association.
The pharmacy has emerged as an ideal setting to foster better patient engagement with preventive care. Many pharmacies offer vaccinations and can serve as a secondary element to driving patient activation in care. Pharmacists who spend extra time with their patients using an ABM program may see even more pronounced increases in patient engagement with preventive care.
An ABM program calls for an appointment-style patient visit to the pharmacy. Instead of a patient stopping into the pharmacy quickly to pick up newly-filled prescriptions, an ABM visit focuses on patient adherence to treatments. Pharmacists can use patient engagement strategies to dive deeper into patient wellness, medication adherence, preventive care, and vaccinations.
In this specific study, pharmacists used ABM programs for patients picking up synchronized medications. Pharmacists checked vaccination histories, disease risk, and administered vaccinations when applicable. These appointments, which also reviewed use of multiple medications, could be extensive and last up to about 30 minutes.
The researchers deployed the ABM program at 24 Kroger Pharmacies in Ohio and compared results with 78 control sites. Pharmacists in intervention pharmacies were urged to target patients at risk for medication adherence problems, vaccine-preventable diseases, patients over age 60 managing more than five medications, and patients at risk for diabetes, asthma, and chronic obstructive pulmonary disease (COPD).
In total, 840 patients elected to enroll in ABM at the intervention stores. Those stores saw higher rates of vaccines.
The mean number of vaccines in intervention pharmacies was 1,810 vaccines, compared to 1,455 in control pharmacies. This result was pronounced for herpes zoster vaccines, where pharmacists administered 167 vaccines per intervention store compared to only 130 per store in control sites.
Patients and pharmacists both reported that ABMs helped facilitate meaningful conversations about vaccines and preventive care, the results showed.
Over 90 percent of patients who completed patient satisfaction surveys said they would recommend ABM programs to friends and family members. About one-third of intervention patients said they didn’t know they had been missing vaccines, and around half of patients said it was helpful to be able to receive the vaccine at the time of appointment.
Eighty percent of pharmacists said the ABM program allowed them to forge deeper relationships with their patients. Eighty-six percent of pharmacists said they were likely to continue offering the program.
Medication adherence and adherence to preventive care is an extensive problem throughout the US. The National Conference of State Legislatures reported in 2016 that poor medication adherence is responsible for 33 to 69 percent of all medication-related hospital readmissions and costs the US about $100 billion annually.
The medical industry also struggles to maintain high vaccination rates among adults. While children must meet vaccination requirements to attend public schools, adults do not face as stringent standards.
Pharmacies have recently come to the forefront for addressing both of those patient engagement barriers. Community pharmacists can address specific issues patients have with their medications, can work around financial or other barriers, and can reinforce the importance of adherence and engagement with preventive care.
ABM programs and medication therapy management programs are ideal settings for discussing barriers to patient wellness. Pharmacists can set aside full appointment times with high-risk patients – patients who may be liable for a certain chronic illness or who hasn’t filled a prescription in a long period of time.
The key to these programs is creating a positive rapport between patient and pharmacist. A trusting relationship will allow the patient to divulge key information that can reveal barriers to medication adherence.
From there, pharmacists can encourage patients to better manage their health and preventive care activities, while tapping resources that can alleviate barriers to medication adherence.