The impact of appointment-based medication synchronization on medication taking behaviour and health outcomes: A systematic review.

WHAT IS KNOWN AND OBJECTIVE: Proactive synchronization of medication refills through an appointment-based model (ABM) is a community pharmacy-based intervention targeting adherence to medications. We aimed to systematically review evidence on the impact of the ABM on medication taking behaviour, health resource utilization, clinical outcomes and the preferences of patients and providers. METHODS: We conducted a systematic literature search of MEDLINE and Scopus from database inception through 6 February 2017. Studies were included if they were original investigations evaluating the impact of the ABM on at least one outcome of interest and published in the peer-reviewed literature as a full-text manuscript in the English language. Outcomes included medication taking behaviour, clinical and economic outcomes, health resource utilization, and patient or provider satisfaction. Data were synthesized qualitatively. RESULTS: Five studies, mostly observational in design and with low risk of bias, were included. Objective measures of medication taking behaviour were consistently improved in patients enrolled in an ABM vs control, indicating an association between appointment-based medication synchronization with improved adherence and decreased likelihood of non-persistence. A single decision analysis indicates a cost savings over 1 year associated with the appointment-based medication synchronization programme modelled, for hypertension, diabetes and hyperlipidaemia. Limited data regarding health resource utilization and clinical outcomes and patient or provider satisfaction exist and are currently inconclusive. WHAT IS NEW AND CONCLUSION: The ABM provides a unique, patient-centred service to improve medication adherence amongst patients taking chronic medications while demonstrating a positive financial return on investment. Future research is needed to determine the impact of the ABM on final health outcomes.